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<br />1 <br />r/' I:i <br />I ! <br />' <br />~ <br />`• ( <br />! <br />`~ <br />/ <br />i~ <br />. . <br />~.._ <br />/ <br />~ -r \, <br />_. <br />... <br />. <br />...... <br />te ~ <br />PE rm1C Cti'C NGtlll¢': l!C'~ ~;IJ IL :: V:: !'V IIC'f l'lF IJLV <br />Pex'miC Nu. ~ ~ 7'' ., ,_., <br /> <br />~• .: <br />Operat:on Namur: .,.:.~::~, .. .. i~: r. <br />Anniversary D3rte: Jam:a:y 'd;, `a(+xv <br />/ <br />Total: ~~,Y•4.: ,.. .._ _. - __.., ::acy .:a l_4r <br /> <br />~ <br />C~ <br />\~' <br />~ ~i .. <br />~ <br />~ <br />~ <br />b. county ..car.:. «•:ce ,s loea t <br />" <br />1, a. Permitted acre-.cge: ed ~~ <br />rr, <br />.~1^~ ? <br />2. Has cl:.., mine bee'. yran Cpa :'ES!t,e;v.l?Y ~e..,~: P.iN ,.: h'!JS% YES ~'0 .. L. <br /> ~, . <br />Does this mine ct: ~•:?ce _. _. :. L'SS ct••a ~J da,.~ per yeac% ^ORE LESS <br />3. Dons ch:s mane hac2 a P ~ ed rec:a•Li::~. Ian'' YES ,.NQ , <br />4. Total acres aiier:a;i dur:r:,: _.., :epc--:: /out: ti ~,~r'.':~ <br />~• <br />5. Tota'_ acroe reclax.. sd f^, the _ ^crt .._~ .:, <br />~ <br />~ <br /> ~ ~j( <br />'~f <br />• <br />6, Total nwrJver of acLes in top5r~:l replacement stayer ,lac; <br />-•~---i--`.K <br />a, Rverage thickness o' wpso _'_ re, iuced ~. ~ Ir <br />7. 4bta1 number of ar xGS secc'<-.a ` r._ <br />a. List species~.~,ded ta -;.,-,~ v raw .,~x c6{w /ar ;,coca .• '+s ,f. <br /> ~ <br /> ~ <br />~ <br />cr.c.~~.r ;vus, d <br />• 8. ~ 1°or nvn-Phased olx rations prov.dc dul.c~, F• "~' <br /> <br />a• Date reclamauo:~. beyan: ,_.. .. .,... r <br />---.-.-~-1=+~a:1;'{j'j! <br /> <br />9, The type and approximate quancxcy of fertilizers, orcJan!.c material or soil ,roc;. a <br />~ :': <br />y. <br />,.,J <br />conditioners used for the ~ep.~rt year:• _ _Y~_ , <br />? ~~ <br />10. Estimated total acres Co oe affected :n the ne~;t report year:' ~ q <br />aC. +Y.~ <br />.. L1. COMMENTS: \`~ <br />¢~ <br />S'A`t"1'Z (Z .~,'W ~y~\ \ <br />w~a'~.~~ ~ .;;'.3~;'~..<`. <br />~' e.:: <br />,A <br />_ <br />-' - ~. rF_, ,~,. <br />i <br /> <br /> " <br />Please show the lucac.on of the ac•re;,ye for .-e,,.., - C as yvcr ma P"'~ Indicate ~ <br />" <br />the phases of the recla~.z"•.on dt:cr ^~/ been. c:o••~.,.-c~,. •. c:re::,ted ~,icr. your clrnetpbla q~'~r, <br />For phased operation's sr`c, daces c•.;.-I .:on ce~ISeci ar<i C:cte, r~_~:':rruticn_ beyan :'r~,ES~tf,"~~." <br /> "w . <br />' NOTE: iE there have not been ~~ c::a:;yc•s s:r.ce .,_ lt~sc ,......•,a: ceporc and you <br />previously su~ou•,icced a m ..: i ~~ _:cct_y ci~I. iccs pile c ~rxcra ac reuye in <br />;~ <br />items 2 chrougb <br />: ~~` <br />b, then a new map xs un7~ - ;sa ~. .. ..ver, tors rr_sc '~e .,tac6d above. ,T,, <br />'{~~ <br />_.__.~ <br />~~ <br />h ~~ ~ ~ ~ c <br />wTC^f~ <br />Signa ucra; _ .. < ~,, <br />Please type or print currar.: cor•tace ~':•re, r•liny adcir~r,s, ;ir:d Phvne number below: '~ `''+~~ <br />Con CdCC Name •, ~--> ~~\," P,~` phU n2: ( y ~' ~~3 ~: ~~.~'f; .'~'~ <br />~, <br />Com <br />an <br />; <br />~ <br />' ~ <br />p <br />y <br />S,L_111_ <br />y --mac <br />y ...,a <br /> <br /> <br /> <br />~:~.~.~,s ;, ,.,~S-t=--~~--`-~-3v {: <br /> ~ <br />: <br /> :c: <br />; <br />; <br />1 ~ <br />, <br />\ \ <br />V <br />\ <br />l <br />Federal Tax ID No. or Social Seca c. cy nlo.: <br />c..J ~ <br />1r ~ ` •1 '... <br />- <br />. <br /> <br /> <br /> . y~P.. <br /> • n% <br /> •u <br />, i +M -. <br />+. <br /> . <br />~~ <br />~ <br /> {'y'.. <br />• t~9'~ <br />I' <br />