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• • <br />-2- <br />3. Address and Phone Number of 2US~C G ~vi9 !> ~'7 ~/ - 415 ~ <br />• Local Offices j~E;_;q~Co.81y~~ <br />4. Address and Phone Number of S'/arh E <br />General Offices <br />5. Name and Phone Number of Person NA 20 ~ D ~ ~o i 5 ,Q KA N D 3TA D T <br />Staff Members Should Contact $?,~ _ [~ y S' 9 <br />6. Owner(s) of Record of Affected Land /i!A2Cl.p BRaNDSrAb7 <br />(surface area} (If more than 2, list below)LoiS a2,a,.~DSrADT <br />7. Owner(s) of Substance to be Mined NARO~D BRAG DS TAD; <br />(If more than 2, list below) Lo .s j3RA..lOSTADT <br />8. Source of Legal Right-To-Enter COPY or TAx 2ECEiPT <br />(Indicate what type of proof is <br />included in EXHIBIT G - lease, <br />deed, notarized letter, etc.) <br />9. Type of Mine and Substance to be Mined CrR~4~ <br />(Specify underground, open pit, <br />quarry, etc. & substance(s) to Roc-K t~,'r <br />be mined) <br />10. General Location and Elevation E ~e J • ~, a $ o ~ <br />(Miles & direction from nearest APPQo~ r.( „~; ACS E, ~F L7 c ~ to <br />town & approximate site elevation) <br />11. County •DE ~? A <br />12. Acreage of Affected Lands ~ .r !a ~ <br />(Total surface acreage to be <br />included in permit) <br />13. Application Fee (See applicable 'a; eJ ~ <br />Rule to determine amount) <br />