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THIS PERMIT IS ACCEPTED SUBJECT TO ALL ITS TERMS AND CONDITIONS. <br />BEFORE ANY PERMIT IS ISSUED TO AN ENTITY, DOCUMENTATION MUST BE PROVIDED TO THE <br />RESPONSIBLE OFFICIAL OF THE AUTHORITY OF THE SIGNATORY FOR THE ENTITY TO BIND IT TO THE <br />TERMS AND CONDITIONS OF THE PERMIT <br />ACCEPTED: <br />Jim a Miller <br />General Ma#ager <br />Mountain Coal Company, LLC <br />APPROVED <br />/ <br />royles, Dist t Ranger, Paonia Ranger District <br />evi <br />SIGNATURE <br />SIGNATURE <br />DATE <br />4,0 <br />"72240/ f <br />DATE <br />According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a <br />collection of information unless it displays a valid OMB control number The valid OMB control number for this information collection is 0596- <br />0016 The time required to complete this information collection is estimated to average one hour per response, including the time for <br />reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the <br />collection of information <br />The U S Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color national ongin, <br />gender, religion, age, disability, political beliefs, sexual onentation, and marital or family status. (Not all prohibited bases apply to all <br />programs ) Persons with disabilities who require alternative means for communication of program information (Braille, large pnnt audiotape. <br />etc ) should contact USDA's TARGET Center at 202-720-2600 (voice and TDD) <br />ro file a complaint of discrimination. write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington DC <br />20250-9410 or call (866) 632-9992 (voice). TDD users can contact USDA through local relay or the Federal relay at (800) 877-8339 <br />(TDD) or (866) 377-8642 (relay voice) USDA is an equal opportunity provider and employer <br />The Privacy Act of 1974 (5 U S C 552a) and the Freedom of Information Act (5 U S.0 552) govern the confidentiality to be provided for <br />information received by the Forest Service <br />Page 8 of 8 <br />