|
1
<br />.'Pe rmi CCee Ntuna:
<br />' ParmiC No. :
<br />~ Operation Ntunv ~,
<br />Anni va CSa ry U:~te:
<br />Total:
<br />~.
<br />.. ~ ., ._ ~_ _~.:•i ,.~.__ bi., .,,-~ r,~.~., ~i.ir,iu,
<br />~r ~ ~ ~::~: i. ~ ,n ~:.: i. r:i r.::~. i~i.i,:~,:: i~.~:j.u(r
<br />1, a. FErmitced acre:~ge:
<br />2
<br />3
<br />d.
<br />:.
<br />6,
<br />7.
<br />9,
<br />10,
<br />11.
<br />.. ~.. Ouiu: c;~~ii C'OnC'[l'CC U.~:~
<br />~ ~ '~~~~~ b. COUn"y '....c.. !nine is 1GCdCBd:
<br />Has this mine been granc~ii '.'C'^~PUit;. i2Y t"c55h'ifGN ...~~"t'US%
<br />DOES CIli3 mine OFel eta ?~!:. ~r_„ ~. LG55 _..^.an '_'-30 .d'J5 pCL `yea C?
<br />
<br />Dues this' mi ne hdva a P:`.a Er.a [cc i a(:'.a ::4r. lce . ~~Vr„~Y~~~~
<br />'Focal acres of fEC:ad ciu r_ ny ch.< :-epo:'_ y~~a.:• eet,' 7
<br />JHN ~~Z~
<br />Total acres recla!::~od for
<br />r.:
<br />:he oerc .._.
<br />`~~~ ~ ~/
<br /> l)Ivisi
<br />
<br />Total
<br />number
<br />of ac:-,.,s
<br />ir:
<br />Copsvil ,
<br />rep'_aceinent on nt~eclarnation,
<br />staye:Minjnga
<br /> nal$LfQty
<br />a. A veraye thickness oc topso:? replaceu.
<br />'T'otal number of acres sec~ cl,~c
<br />a. L isC spa t ies .,.rd ed v .,~vu'.:'. y racy .:~~ rc q,v: ~: ymar ,. rack
<br />I'or non-phased onc~i ::cions~ prcr. cl~:. daces ~.zc tau: ~:~,r.; cc~us ed~~
<br />a. Date recl~amaCtor. began:
<br />c
<br />Y..S 0
<br />^.ORE LES$~. ~.
<br />YES , NQ,,-.
<br />_ ~. ...: f.:..ii
<br />The type and approx.: mate dL:ar.city o: ferci Lzers, organic rna serial or soil
<br />conditioners used for tht~ rrp~_rt year:'
<br />Estimated total acres co be affected in [he ner;c report year:"
<br />C0DPIENTS:
<br />t i
<br />.T,.,r-- ai lTl.
<br />r'
<br />'heY
<br />~r -i
<br />r
<br /><. /a r °,,
<br />~Y~~ ns
<br />' Please show the loeatton oC :F:a acre~.ye Cot ..a....., - E on your map" Indicate'
<br />the phases of Che reclama~:on ~Nn_cr, nave i:eer~. co:~.~;i:ec~~,:~ ..rre:aced ~;!t.. your ti[naC3<bl,e.•,
<br />For phased operations sho:; ;laces aaC:-occ:on ceasaci ar.ci e,.r es .,.carnet ion .began. ';.,Y
<br />~~ "" NOTE: if there have r.ct been arty c::anyes s:~:ce _...: ias. .......;' report and you '
<br />previously suiiiaicced a map :vhic6 t;,:rc~ctly depicts the curccr.t ocreaye in kerns 2 ~throuq
<br />6, Chen a new map is unnacedsary. .,,:;ever, this r^cst he stated above.
<br />., Please Cype or print curter.: eor.tact n':ma, catltny address'
<br />Contact Name: _.~ ~\~,~~__
<br />~;° .
<br />Company: ~__C_ ~; ~ „~
<br />Addrzss: (~~~~7 CJ ~~?~`yl
<br />`~1NShv. r.t4 ~y\ c~•ZV
<br />
<br />y ~ `' ~ ~ ~ ~ `~~~~ ~ ',,,,fit. ' f!'-
<br />Federal Tax ID No. or Soctat Setcnc :~o. ~. .. y.,:;
<br />... .(t%.' ..
<br />L~z,~
<br />~~::'. f~
<br />. ~.7 ~', )~d>jr«
<br />'y
<br />~, .1~ ('.
<br />r.ma~~
<br />s, t,nd phonennumber below: ";';,;;~:``~
<br />Phone: : ` a~-ogs ,
<br />.. p 5~';.
<br />F'i.:! NU:
<br />%:ar.
<br />
|