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_ . ,_ III IIIIIIIIIIIIIIII ~ ' ~ ``'~• ` ~`' <br />ggg M LAND WILDLIFE QUESTIONNAIRE • ' <br />For Limited Impact and Select Regular Mine Applications QUG ~ I1~T <br />I/ M~nao ,_anr.i <br />1. Name of Company/Pfine: ll rpr,)n . COt~n~v _Tj/~5 P r RN;~loti, ' <br />2. Name/Addre:;s/Phone of Contact Person: l5 ~oria. ~ecli t ~(}. ~~X ~ 41 •r .E,[l0'S <br />~~ 8103 ~, ~ Phone ~o. 71~~ - 43~- 5 s io <br />_ _ t.. <br />3. Location of- Mine:Cror~l~PV Coun-~v 1111J4of ~t4 ~ Sl~)4o~' St4 ~ 20 1?555~•~5` <br />(County, 'focroship, Range, Section t nearest quarter quarter; Exhibit A-PfLR appl.) <br />4. Nearest Torm/General Location: f (~ m; les ea5'~ S ~i .r~r C ~+~ <br />5. Land Owner:~hip (Cirncle) 1. Private 2. BLM 3. USFS 4. Other <br />6. Present Land Use: POStr.rP. ~anc~ ~or C.nTr~e <br />7. Proposed Final Land Use: ~n,5'ftirP. ~nnr~ *~r Cu F) fie. <br />8. Type of Operation: 1. Surface ,,. 2. Underground <br />9. Pfinerals being mined: Q ~"(/ U(~, <br />10. Number and Descriptnion of Surface Acres Disturbed by Mining/not including roads <br />(Exhibit D-PfLR): `-( ~ RcreS <br />11. Miles of reads to be constructed: ~~ ~¢. <br />12. Life of Mine (years): p~r9w V- L1N Know~1 <br />13. Description of Operation and Reclamation -- Additional sheets may be attached <br />(Exhibits B b E-MLR) _ <br />! h~.j}~5 ~'J~O' ~.ono~ h~,~1~c~n' lr9ide rr~~unnino 4~nr+~t ~ Sou~~ lUsino tlozer <br />~$jy~JCr~ ~ + Du5 `+ TnA Soi 1 t<-o +ar~'{le5f e45+ bowrw~4rd ~7 ~~P.n O~lSh <br />Ol/er}~u_rs~en inside, ~~' fopso;l. 11sV;no~1a c~1~zer nl;Ile ornye! ~ e.~cGaVaf~, <br />.)rift I~or~P.r L1eY-~ Ooinn ~0 4)dY'n JVer~rt- SnuTYl ~ __ _ <br />. <br />i,aere ~ina~-Fn ~ s~ aJer ~]ur~.en 6ac.K •1y1 d• .Slone ban Ks ~-O 3-IS~Nes <br />~~P r'1 ~ Al~r Y DyPr bltrd ert r ii-I-h ~-q" o~+o .~so; ~ ~_o~ r+{-roJer Crnr~ ~I- <br />~S~}o ara55 <br />14. 'Please enclose Maps of Project Operation, Disturbance Areas and Reclamation (Exhibit <br />C.) This u:ill(~exipedite process((~~ing. Your cooperation is app/recira~t ed. <br />15, Prepared by:.l~i~R~ (' A~Pn~1i}pnn~ Date: (~ - [ ~' l l <br />-~ Pacr, 1 of 2 <br />