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i/i7 <br />MINED LAPID RECLAMATION <br />Restular (1~ Permit Application Checklis~ III IIIIIIIIIIIIIIII <br />(File No. ,~'-/3~ Name BLUE ~/E'T M~n~iry(r Date of Filing (Completeness) <br />ITE:4 COMPLETE ADEOIIATE COMMENTS <br />Aonllcation Form <br />1. Name of operation " .8u/E ./E'T #~ <br />/ <br /> name of applicant / <br />3. Address 6 phone (local offices) <br />4. Address S phone (gen'1. offices) <br />5. Person to contact ~ <br />i / <br />6. Parent corporation (if any) I / <br />4. Surface owners I / ~ <br />3. '_fineral owners ~ <br />i / <br />9. Type of mine/substance ~/ ' <br />0. General location fi elevation I V <br />1. County ~ / <br />Z_ Acreage ~ t/ <br />3. Fee ~ / ~ <br />4. Present land use <br />.5. Surrounding land uses <br />.6. Proposed future use <br />i <br />.7. Other mining permits l/ <br />.3. Signature / <br />.9. Prohibited Lands Statement / <br />`fags 6 Exhibits <br />1. Legal description <br />2. Index map <br />3. Pre-mining 6 mining plan map I ~ I <br /> <br />4. i <br />Mining plan - a) Cimetable ~ <br />iY <br /> - b) depth S thickness o° ore -a~,c i <br />~ ~V U <br />bode <br />