Laserfiche WebLink
i/77 MINED LAND RECLA"LSTION III IIIIIIIIIIIIIIII <br />sss <br />Regular (112) Permit Application Checklist <br />File 'Io.?.'-3ilz *Iame ~P~n.ver ~s'~•tc(~-el--~;p'L Date of Filing (Completeness): <br />ITEiI COMPLETE ADEQUATE COMtiENTS <br />Application Form <br />1. Name of operation <br /> <br />// <br />2. Name of applicant ~ <br />3. Address ~ phone (local offices) ~ <br />4. Address ~ phone (gen'1. offices) ~ <br />5. Person to contact / <br />j // <br />6. Parent corporation (if any) ~ ~ <br />7. Surface owners <br />8. *fineral owners ~ ~ <br />9. Type of mine/substance ~ <br />L <br />'.0. General location ~ elevation / <br />( !/ <br />.1. County ~ ~ I j <br />L2. Acreage <br />- ~ <br />Y/ <br />~ <br />.3. Fee i ~ ~ Nee <br />.4. Present land use ~ C~ <br />_f. Surrounding land uses ~ , <br />/l <br />.6. Proposed future use ~ G~ <br />.7. Other mining permits ~/ <br />.8. Signature N~-~ ov:~;,~~ <br />.9. Prohibited Lands Statement <br />naps 6 Exhibits <br />1. Legal description <br />2. Index map /jam <br />3. Pre-mining 6 mining plan map L <br />~ <br /> <br />4. Alining plan - a) timetab'e I , <br />/ <br />v <br />~ <br />- b) depth hickness of ore <br />I j <br />• <br />body <br />