PERMFILE138381

• Permit No: M1980203
• IBM Index Class Name: Permit File
• Doc Name: APPLICATION CHECKLIST
• Section_Exhibit Name: EXHIBIT A LEGAL DESCRIPTION EXHIBIT B MINING PLAN EXHIBIT C MAP EXHIBIT D WILDLIFE WATER RESOURCES
• Media Type: D
• Archive: No

]/7 III IIIIIIIIIIIIIIII 1/y APPLICATION CHECKLIST L -~
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LIMITED IMPACT 1110) ._ NAME ~~~ - FILE k z~-~
SPECIAL 10-DAY (111) _ COMPLETE (FILED) DATE
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ITEM ~ .~ .. COMPLETE ADEQUATE COMMENTS
Application Form: 1 -
1. Name of operation `~
2. Name of applicant/operator ,
3• Address 6 phone, local <.
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4. Address E phone, general / ~~
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5. Person to contact i / ,
6. Surface owners ~ L/
7. Mineral owners ~ ~~
8. Source of legal right-to-enter ~-
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9• Type of mine/substance
10. General location ~ elevation
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11. County
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12. Acreage '? ~
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13. Fee ~
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14. Present land use C /-
15. Proposed future use ~ ~
16. Signature /ice
Maps and Exhibits _
EXHIBIT A - Legal Description '- ~~~
EXHIBIT B - Mining Plan '- ,'/
EXHIBIT C - Map
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EXH IBIT D - Wildlife Water P.esources- r
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Vegetation'~Soils Information~~