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• III Illllllllllll III • <br />DIVISION OF MINERALS AND GEOLOGY <br />Limited Impact 110 Construction Materials Operation <br />Application Worksheet/Checklist <br />New App: / Amendment App <br />Operator: Sutherland Brothers. Inc. <br />Mine Name: Weimer No. 2 <br />Conversion App: <br />Mine ID: M-96-031 <br />Submittal Date: <br />APPLICATION FORM (Rule 1.41: <br />APPLICATION ITEMS COMPLETED <br />1 <br />-------------- 2 <br />-------------- 3 <br />-------------- 4 <br />-------------- 5 <br />-------------- 6 <br />-------------- 7 <br />-------------- <br />/ / / / / / / <br />8 <br />-------------- 9 <br />-------------- 10 <br />-------------- 11 <br />-------------- 12 <br />-------------- 13 <br />-------------- 14 <br />-------------- <br /> <br />Initials Signature Notices COMMENTS: old form replaced <br />/ / / <br />EXHIBITS <br />A <br />-------------- B <br />-------------- C <br />-------------- D <br />-------------- E <br />-------------- F <br />-------------- G <br />-------------- <br />OK / / / / / J <br />H I J L Geotech Sign Affid. <br />? / OK see B / <br />COMPLETENESS COMMENTS: <br />location of site is difficult to pinpoint, most documentation states it is within 1 mile of either <br />Nucla or Naturita, but Exhibit H states there are no Municipalities within two miles. <br />