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DECEIVED <br /> • <br /> REGULAR (11: III I II I II'II IIII �II CNG OPERATION FEB 2 1 200 dftsss division of Minerals and Geology <br /> HECK ONE: New Application (Rule 1.4.5) —X�.- Amendment Application (Rule 1.10) <br /> AFF�b L--/�A 6Xe_E1A*t6E- <br /> Conversion Application (Rule 1.11) <br /> Permit # M- '77 - q13 (provide for amendments and conversions of existing <br /> permits) <br /> The application for a Regular (112d) Designated Mining Operation Reclamation Permit contains <br /> three major parts: (1) the application form; (2) Exhibits A-S and Geotechnical Stability <br /> Exhibit, as required by the Office, and outlined in Rules 6.1, 6.2, 6.3, 6.4.19, 6.5, and <br /> 8.0; and (3) the application fee. When you submit your application, be sure to include one <br /> (1) sicrned and notarized original and one (1) copy of the application form, five (5) copies <br /> of Exhibits A-S and 6.5 (Geotechnical Stability Exhibit) ; and a check for the application fee <br /> described under (4) below. Exhibits should not be bound or in a 3-ring binder; maps should <br /> be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the <br /> information in the format and order described in this form. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly, in the space provided, all information described below. <br /> 1. Applicant/operator or company name (name to be used on permit) : <br /> /�dc Y DEV�I�+-t &. L1At4*K HIn16- <br /> 1.1 Type of organization (corporation, partnership, etc.) : g Pgje q"aA1 <br /> 1.2 I.R.S. Tax ID No. or Social Security. Number: —(0!l-86v'j(o <br /> atOperation name (pit, mine or site name) : dUXiJ4K MIAfF" <br /> 3. Permitted acreage (new or existing site) YSU permitted acres <br /> 3.1 Change in acreage (+ or -) (amendement or conversion) "'�+� acmes A <br /> 3.2 Total acreage in Permit area �$ZO!Z acres <br /> 4. Fees: o 4 E� eAAAI&P. 9.'T5'A. A btD *b; ,9.�tS'^ a�1�•Q. <br /> 4.1 New 112d(1) Application (affecting less than 50 acres and extract less than 1 <br /> million tons per year) $3,500.00 application fee <br /> 4.2 New 112d(2) Application (larger than above but affecting less than 100 acres and <br /> extract less than 5 million tons per year) $6,000.00 application fee <br /> 4.3 New 112d(3) Application (any other operation) $8,000.00 application fee <br /> 4.4 Existing 112d(1) Amendment $2,000.00 amendment fee <br /> 4.5 Existing 112d(2) Amendment $3,500.00 amendment fee <br /> 4.6 Existing 112d(3) Amendment $6,500.00 amendment fee <br /> 4.7 New 112d(1) Amendment $2,500.00 new amendment fee <br /> 4.8 New 112d(2) Amendment $4,000.00 new amendment fee <br /> 4.9 New 112d(3) Amendment $7,000.00 new amendment fee <br /> 4.10 Conversion see above application fees <br /> 5. Primary commoditie(s) to be mined: Arc-�'81��ltTB- <br /> 6. Name of owner of subsurface rights of affected land: 5A#*t& /}5 A16.1 <br /> If 2 or more owners, refer to Exhibit O. <br /> 0 Name of owner of surface of affected land: 75*0C A'5 Atd. L <br /> 8. Type of mining operation: X Surface _ underground <br />