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/-? ~,~~! Ic.:7~~n c-.:::_I_T o' IIIIIIIIIIII I 83-/g7 <br />LIyITED !P'PACi (1!C) ~ `l„TE~~^^ ~a-~'~`~ FILc <br />SPE:IAL 10-DAY (111) _ CCyP!cTc (rILcO) DATE <br />ITcy CDNPL=~E ADEQUAT_ COyME.'!TS <br />ADOiiCatiCn FC rT: <br />1. Namn of operation <br />~~ <br />2. ?lame of applicant/operator I ~/ ~ - <br />3. Address b phone, local <br />y. :+ddress b phone, general I i <br />I <br />5. Person to contact ~ I <br />6. Surface a+nnrs f / • <br />f <br />7. yinnral owners <br />~. Scuren of legal right-to-enter <br />3. Type of mine/substance <br />10. General location b elevation <br />11. Ccun:y I I f <br />i .. .Acreace <br />-1 ~ °__ I i <br />14. Present land use <br />15. Praoosed f:~:ure use ~ I <br />f ` <br />i <br />15. Signdturs <br />yeas and Exhibits <br />EXH131T A - Legal Description <br />v - - <br />,~- ~~f 7 <br />EXH131T 9 - Yining Pian / <br />~/ I <br />! <br />! ~E G <br />./ <br />EXH 1 9 1 T C - yap / <br />_XH '31T D - '+i !dl i .`e, '.+'ater Rescurcas, <br />~leaetatien, Scii; in'or-acicn <br />~ <br />