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(Not for DP Entry) <br />Permitted <br />Actual <br />Proposed <br />8. Mineral ownership: <br />Indicate currently permitted acreage for each <br />Federal: acres <br />1,020 <br />1,020 <br />0 <br />State: acres <br />0 <br />0 <br />0 <br />Private: acres <br />8 <br />8 <br />0 <br />Indian: acres <br />0 <br />0 <br />0 <br />9. Surface ownership: <br />Indicate currently permitted acreage for each <br />Federal: acres <br />1,020 <br />1,020 <br />0 <br />State: acres <br />0 <br />0 <br />0 <br />Private: acres <br />8 <br />8 <br />0 <br />Indian: acres <br />0 <br />0 <br />0 <br />10. Affected area (in acres) <br />38.6 <br />37.2 <br />0 <br />11. Disturbed area (in acres) <br />20.2 <br />18.8 <br />12. Acreage of area reclaimed in previous permit term <br />A. Backfilled and graded <br />18.5 <br />18.5 <br />N/A <br />B. Retopsoiled <br />17.2 <br />17.2 <br />N/A <br />C. Reseeded <br />18.5 <br />18.5 <br />N/A <br />13. Acreage for which bond has been released <br />A. 60 percent <br />N/A <br />B. 85 percent <br />0.0 <br />0.0 <br />N/A <br />C. 100 percent <br />0.0 <br />0.0 <br />N/A <br />14. Renewal Term Requested (Years) <br />N/A <br />N/A <br />5 <br />Note: If the application contains proposed (new) acreage, then a permit revision application <br />form must also be completed for those acreages. <br />3 <br />General Description (Miles and direction from nearest town and approximate elevation): <br />Eighteen miles north of Loma, approximately 5,740 feet above mean sea level (MSL). <br />15. Type of Mine (Check one): 1 Underground _ Surface <br />Combined Surface and Underground <br />Loadout Other <br />Revised 05/07/12 <br />