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_ _ • ~ ... _ • iii iuiiiiiiiiu iii <br />. ` MINED LAND WILDLIFE QUESTIONAIRE <br />~~y~Yd~V <br />~l for limite1d impact and select regular mime apfplications D~6u~~p~ <br />1. Name of Company/Mine: ~d~~~~ ~~~~'Z-~~1V11LyQ~~r~M <br />2. Name/Address/Phone of Contact Person: ~.~~ti1a Vtl LD V M1ONPIw <br />© tto~i/0 <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />11. <br />12. <br />13. <br />Location of Mine: ~~:S4H° <br />(County, Township, ]range ~// <br />Nearest Town/General Location:/~"_'I~",~~a~~ ~~~ 0~'~~gQi~Vy~~p~~)~ <br />~z <br />Land Ownership (Circle) 1. rivati~ 2. BLt•1 3. USFS 4. Other <br />Present Land Use: (y~j~q~lpb~ ~oYi~, Q ' 9 ~~ <br />Proposed Final Land Use: ~ bF3p ~ ~ ~ y ~ 1 IN ~ sl ,~ <br />1 aj MT r - ~ <br />Type of Operation: 1 Surfa 2. Underground <br />Minerals being mined:_~ ,~7) ~~©6}~~ ~N, IJ~NI~ ~j~~/ SahJ s~~~' `~ <br />Number and Description of Surface Acres Disturbed by Mining/not inc uding roads <br />(Exhibit D-MLR) :~~e ~'~ ~ ~ ~. ~ ~"j [ r~ ~ y d t <br />Miles of roads to be constructed: (~~~~~~ _ <br />Life of Mine (years) '~_ <br />Description of Operation and Reclamation -- Additional sheets may be attached <br />(Exhibits b E-MLR) <br />U <br />-4 ~~_ <br /> <br /> <br />--~-~ ~ -. <br />r+a <br />.;~ <br />c <br />~~ <br />14. Please enclose Maps of Project Operation, Disturbance Areas and Reclamation (E:ci~init. <br />C.) This will expedite processing. Your cooperation is appreciated. <br />15, Prepared by: ~~;'~~^ ."!'~ Dater"", ~ ~ ~ _ <br />. A ~ <br />Section to nearest quarter quarter; Exhibit A-?iLR app L.) <br />