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<br />/ Per.nr[ NO. : N 24 2000
<br />Operation N,una: v,cl ~ '~!. .. b:l 0117S10n 0/M~
<br />Ai:niversery U:~v~' _ rr_.,:'.. _. `~Op~ ~~ah&Ge01o9Y
<br />1. a. Pzrru[czd ac re ,~z' \ ~ ~' `~~ ,_. C'ocn•. y _:.. :..:::e zs !ccaced: `+Il-~ r
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<br />Has vl;is mine bear granv.~.~ :Ct.~r~_.:,;,.:'r ~'L:S:~.~!'[u!" .,.,..:.> YES ©0
<br />Does this mcne ope: .,te ~•: ~.:~:~ :1 :.cSS .`•..u: :d~ per ,car' ^.ORE LESS '
<br />Dees ch~s m_ne hc~,..,_ a p':.. ... . ~-, im^:r. ~. ... ,. yES Np
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<br />':VCal acres ai fzc': ~_~i der::.; ~_.. :~p~: ~. ~~<~: .. ".:;fir'. ;.
<br />Toca! scrr,e reclazr:d fo: _._ ?crc .._. ~ ~~ .,
<br />Total number of ac: as Ln topsoil rep_acemen[ svaye: ~~~~„f;.
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<br />a. Average chickn~ss oc vopso_: rep:acc~.i _
<br />':'oval nuauer of <c':..-,, sr.: '.. ~ ~~~;;.•
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<br />[y, oryan:c maverial or soil ~ - ~.'~;~!"
<br />1'or nvn-pnased op~~l .~crons prop: :ch: ciw. moo; "~.c r;~,.i „~ ,. ~~u ~: ecl
<br />a. Dace reclamation beyan:
<br />The type and appror.: mace ~:ancrcy of fErcil_cer:
<br />conditioners us~ci :.,r ch. ~ .-~. ~car'•
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<br />on of •.!~.~z ac~e.,~ir !,r ;ve~ c•; 4 - C on you: map•' Indicate
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<br />For phaszd ope raisons sr.o.: iac rs c.. _:..~cc .on ceasea anti ~
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<br />"• NOTE: If there have r:oc oxen ~,r; rues sv::_ _,._ .-,__ ... .~..;! rtpcrc and you ~.
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<br />previously submcvc2d a map ::hrcr. ~,.. ccr.L _y' ueliicvs cne c•.rccnc
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<br />6, Chen a new map is unnece ssary . ...'::aver, viiis muse ,
<br />oc. stated aboie. 7""'
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<br />Please Cype or print currant cocvac: c-:~,~r~,-, :r:,l::r,y a~lc,r~.:,y
<br />contact Name: ~ ~~~,~. (1~
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<br />Addrass;~~_\~_r~~ y~_~~~~
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<br />and pncne number below: '' ',,;.. ~'r,!f.
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