Laserfiche WebLink
..: <br />MINED LAND RECLAMATION <br />4/77 • * III'IIIIIIIIIIIIIII <br />Re.Qular (112) Permit Application Chec1~1 ist <br />File ilo,~~' 77 147 Name l-~~w a ~o/c /~/I,ci,il,._ G_ t-~we ~ Date of Filing (Completeness) :_ <br />~li~ <br />ITEi•S COMPLETE ADEQUATE COt4SENTS <br />Application Form <br />1. :flame of operation <br />2. Name of applicant <br />3. Address 6 phone (local offices) ~ L/ <br />4. Address b phone (gen'1. offices) <br />5. Person to contact <br />ti. Parent corporation (if any) 1~ ~l/~ <br /> <br />7. Surface owners ~•.. . <br />3. i4ineral owners <br />i <br />9. Type of mine/substance <br />0. General location & elevation <br />1. County I I ~ ~ <br />A <br />re <br />e <br />2 / <br />ag <br />. <br />. <br />c ~/ <br />~ <br /> <br />F <br />3 / <br />// / <br />!/ <br />. <br />ee i ~ <br /> ~ <br />4. Present land use ~ t/ ~ <br />~. Surrounding land uses <br /> <br />6. Proposed future use ~ i <br />~ ~ <br /> <br />7. Other mining percaits ~ <br />.8. Signature <br />i ~ <br />9. Prohibited Lands Statement <br />'Maps & Exhibits <br />1. Legal description <br />2. Index map <br />3. Pre-mining 6 mining plan map ~ <br />i <br />4. t•Lining plan - a) timetable ~ <br />- b) depth b thickness of ore <br />: <br />7 <br /> <br />~ :. fi <br />r, <br />,' r <br />5 <br />r <br /> <br />pony <br />