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Y Yl);12EBY AGI2Li•;''FU COMPLY KITH the spee'tal conditions as set forili below. I CLT, [2'fIP''Y`That the: (a)' materials
<br />to be a~emoved are. to,be used for.fhe~~pgr(rose noted above; (b) gone of,tlie materials reUuived are,to be.sold or barLeYed;
<br />(c) removal of matei~ials can Ucgin ~unly~ upon iecelpt of.an approved copy of this permit; aud, (d) the authorized officer
<br />is W be notified upon completiop of removal.,~i ''
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<br />1 CEt2'i'IFY That lain twauty-onayeuxs of age or'older, a crtrzeti of the" Uruled States, aud resic3en of ltre State of
<br />I;oloiaiflo ,;:
<br />I FVa'rxea CERTIh'Y 'T`hat the'statements made by'uie.in this application, are U•ue„complete, aud correct la tlrc hest
<br />of my Imowledge.and belkef and are made in good fgith:..,', ~.~: ,,, _ ~. "
<br />1 Jaiili`xlon '(.°oiuliy Ruad'Depnx'tinon•t .
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<br />_ -p)ete)' - .... 1> y~..r , .:v; .. ~ ;,(SignatuYe'of Appllcaut) ' ' -'_
<br />Title 10 U.S.C: Oectiou tU01 malrer'..~At v crime'Epr any"person kudU+ru0l.yi.nud rveHfiilly;s afalrnto oiry daparnnenb ur agency of the
<br />United Ste toe auy false, fjetlt{airs°.gn:€ruutlUkgntstutpqrqata ~r ryprc5eytt3~leps ay~fo,gny uwtler,.within ihs jurisdiction.
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<br />'this permit is hereby issued' ior;.YJle mate}isle applied Sor but;,frlay i~G;,_e;~ncel~d rf:,it appeais.,tliat •tltis permit wee
<br />issued eiroueolisly or. t(re'CenpB'ue' C9pa{tiorjS coptaiuGd hee~in axe riot oliserved.'`It sliall be subject Co the Eollowiug
<br />special conditions:. ;. .. ti ~"
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<br />Cuuservatimt pvauticec arust,lre:,practiced. ao provided :. The yetputtea hall ta.eyrn:.i+p'all work areas .aud shall
<br />by tl3 CPR SSY1.1-1(b); ,2-3(c), and ;3~3; .. remove, or "dispose of ,nkl cefuse,' resulting from thu
<br />peemittee's operatiars;. ~'
<br />Equipment, personal property, a.ud improvements"~'tr[ust
<br />be removed witlr.in~'uinety {9U) days"after'.eupiration' ~ .phis permit is issuerl~~under the"Act of~July 3Y,,19a7,
<br />sate (d:, CPR 36'L1.4(e) or 5SYL3-5};
<br />as amended,tend 43 U:S:C:l and Y20Y.
<br />Hny use of the surface"of the: Lands involved in~this' .. .' .. '
<br />permit shall ba such as~uot to inteefai'e wktb any mkniug ~ ~' " ~.~~ ~~. '
<br />claim subject to the provisions of Sectitiu 4 of tpe Act ' ' .
<br />of July'L3, 1955 (30 U.S.C. 6Y3);'
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