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MINED LAND RECLAMATION <br />Application Worksheet/Checklist <br />Regular 112 Application Operator _[•oa~ Cr~k ~2sourut <br />Sapp Rrrd. 4/2o~a~ Mine Name oa rrz rs°u" a o. -g8-044 <br />(i,«plefanrn 1&I•wr~. Lh+,ld6Fi:1~Q1r3~~y/RSo Q • ~• Ca+p1lti`~ q/3p Complete Date q,/go~$8 <br />lKyl$)On IJMx ~afc: //L#g(+ ~LCV •'a H22Td'F.~ <br />Application Fonn: <br />ITEMS 1 2 3 4 5 6 7 <br />Complete: <br />ok ok ok ok dk o~ o,~ <br />ITEMS <br />Complete: 8 9 10 11 12 13 <br /> ok ok ok ok ok o,E <br />COMPLETENESS/ADEQUACY COMMENTS <br />Maps and Exhibits: <br />EXHIBIT A -Legal Description ok <br />EXHIBIT B -Index Map ok <br />7 <br />EXHIBIT C -Pre-Mining & Mining Plan Map(s) Gk ~"y B°~"`"i "`" "' i` °""'"`tiy' <br />of Affected Lands <br />EXHIBIT D -Mining Plan ~ • Nyd"„l,;rrw.~+11- Jv.~ j r,.,c.LL•;r.~f..,,t; aP/r~h a clnr/ynf c~~"nv~ ? <br />• ~ibs lln /~ 5,lrp a~j"r/ 6•IiS Y <br />EXHIBIT E -Reclamation Plan ok Rai, rn~~: ., .;lace: <br /> <br />