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<br />STATE OF <br />DIYWON /1F iEnAMAtlbN. htN~IGANO SiNEI. R EC E I VET <br />~~ <br />1373 sl.erm.~ sti Rom I15 <br />o.~ac caaeaoeoaa~ DEC 2 8 2DQ6 c o c o R ~ a o <br />slant aa3l eewss~ o~ v i s~ o~ o t <br />corst>:lFCrronllf,-ron,ifs REt~tATION <br />rfix: pwf 1322106 Division of Reclamatio , MINING <br />~vfr-Rpl~loe>gexrloyt Mining and Safety & <br />~[(9.AMATfO[flBAi/JfA~lLICA'ilONlOi1tM SAFETY <br />a~o..~ <br />Ceara <br />Q1BQC t7NE Tlxa6 b a YY1171dYsr Attaai! Atllpd b lilt ~ <br />IhasU C~o~ <br />Faait ar . DL ~ ~, (!bast ~aioe ~6e tie nmbes ameeady.aiSateb mit opt" o..m <br />~ IwwApp)jwlias(Rdel.ss) .~A.t^+mlApptic~io.(Rdet.t~l ~or.`ea' <br />_ Cataersisa AFpliuotm(IWe L[ t) "a"'~R"00"" 1'°'r <br />Felmit « ~(: `_ _ {pevl4e fat Aatai~sabaed Ce~rerabas daiads~ <br />1be gipliation for a Ooamuetim Makeitb stapler 1 t2 Operuioa Reelaliae Past aaebiaa tlaaee asjat t~ (t) ~+FP~I <br />fasoc(2Ie-3,Aeaenaml,.sF.eetimtofE>~i-u(ceobrreeaSltu~jSsbbik.na{3)6etpptierbnfee. Whe.yon <br />submit tov appNprioo, ba ame b iaobdt ars (1) seal am p) Davy of ttte eaa~leled <br />+FP~~atwo(1)mpiwa?E~JabihAS.Addeadom 1. apprtpriReeseeNmrof63(Gmkahein13~8dibiCadadieitA+r <br />the appKaHos ke deaaaibed under Saalisa (4) bel6rr. slnetQ jy,Q'j be bad or i a 4+io56idor: asps alai! 6e fLiled b <br />8 i/2' X ! t"ot31r!'X tP fhe. Toea~ad~ewooemot: elerse eaavde tle ia6sloa b tie fimtedaderAexalbed v slit tam <br /> at'S~AI.~PPR <br />A7 <br />N QiF~RMA770N <br />70 <br /> ..~.y~ <br />~.,y <br />~ <br />y <br />. <br />'h'ye~ 1. _` llet~, i 1Ye a~t'e /'."_".~AI~ i~t~a~l •Ts~'r. lals'~. <br /> '~ <br />1. LSDHS seen AHD aHev s7, LLC <br /> 1.1 ]yrpt ~ (~P~41R ~~ LIDQ'PSD LLaBIIdRY COI[PABY <br />2. LaaH;3 aHevs7 PIT a a <br />3. La'te l[lai abase (eery maWr else!: 180.0 P~°i acres <br /> 3.I CAmDeteaaaaige(+) seer <br /> 32 Tab! aasge o F4tail era 180.0 my <br />1. F~ <br /> t.t Ne~Applicaioa <br /> !.2 NewQaaryApplicadae e somtna yryry~vOcallm <br /> 4rt Aaaradmeot Fee 5 1.938.00 ~drYaeot fee <br /> 4S Caavanionb tl2 aperatiae {set by slelMe) ~~.., ooarasioa tee <br />s. seHn aRevsr. ROAD seas sTHDOTORAL FH.7 <br /> S.! -aciieatrlOgmWdoe(s)blea~ L A/d LitJ!'aadar 2. Ald bt/fau/ar <br /> 3. ,$/(! 16e/feasM1t 4. ,A1.A Ildfaaalvr S. H/A [hr/1'm7vr <br />51 MocQakd and see ad'primarF oanaamdiue(a) b la rRiaed~OHCAETII /ASPHALT B[iGR&6ATS. CLA9S PI ROAD Be89 . FILL. ttAT'RL <br />S3 Aedeiptedsadmeafioscideoblamaodme(s)b6emioed: AOAE <br />d6Q of d~a d <br />ethieA lydRaeLiarrlon A,alre ~d kaaFre Mhos <br />