<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 />
|