PERMFILE125414

• Permit No: M1978002
• IBM Index Class Name: Permit File
• Doc Date: 1/12/1978
• Doc Name: LIMITED IMPACT & SPECIAL 10-DAY PERMIT APPLICATION CHECKLIST
• Media Type: D
• Archive: No

4/77 . '~I'I"II'II"II'II •
MLVED LeV~1D RECLAMATION
LIMITED IPIPACT AND SPECIAL 10-DAY PERMIT APPLICATION C:IECKLIST
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File No. 1~~ Name Date of Filing (Completeness):lll,__(7fti
ITEM COMPLETE ADEQUATE COtQiEi3TS
Application Form
1. Name of operation
~
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vu.r~ L
2. Name of applicant/operator J
3. Address S phone (local offices) ~"
4. Address & phone (general offices) ~'
5. Person to contact
6. Surface owners V
7. PLtneral owners ~/
8. Type of mine/substance v
9. General location ~ elevation
I0. County V
11. Acreage
12. Fee
13. Present land use v
I4. Proposed future use ~
15. Signature
Maps and Exhibits
1. Exhibit A - Legal description
2. Exhibit B - inning plan
3. Exhibit C - Map
4. Exhibit D - Wildlife, Water Resources,
Vegetation and Soils infor-
mation ~ ~1011Q2t
I
~. Exhibit E - Reclamation plan ~/