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• , iii iii~ii~iiiiu iii • • <br />MINED LAND RECLAMATION <br />Application WorksheetlChecklist <br />Limited Impact 110(2) Operator ~~u'~en/1~ ~` l~ <br />^ Mine Name ~ . o_~ /P~j~_~~, ~~F~_ _ Q ,' <br />File No. 9/-Q~D Submittal Date _7f3~9~ <br />Application Farm <br />ITEMS <br />COMPLETED 1 2 3 4 5 6 <br /> <br />ITEMS <br />COMPLETED 7 8 9 10 11 12 <br />` / .. ~.: ... c/ <br />MAPS and EXHIBITS... ADEQUACY COMMENTS <br />EXHIBIT A - Legal Description b Location Map <br />EXHIBIT B -Site Description <br />a. Vegetation & Soils / <br />b. Wildlife <br />c. Critical Structures within 200 feet and offsite damage <br />EXHIBIT C - Mining Plan <br />EXHIBIT D - Reclamation Plan <br />a. Plan .~ <br />