Free 20065.pdf - Indiana


File Size: 24.5 kB
Pages: 1
Date: October 10, 2006
File Format: PDF
State: Indiana
Category: Government
Author: bmiller
Word Count: 146 Words, 875 Characters
Page Size: Letter (8 1/2" x 11")
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http://www.state.in.us/icpr/webfile/formsdiv/20065.pdf

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REPORT OF GRADING - MAPS
State form 20065 (R2 / 6-06) Form R-300 Indiana Department of Natural Resources Division of Reclamation

I,

, as the responsible official of Company, depose and say:

That we have graded the areas listed below in accordance with, or in excess of, the requirements specified in our Plan of Reclamation submitted to and approved by the Director. That this area is now eligible under Indiana Code 14-36-1 for inspection. That the attached map is a true plat and correct description of the land we have graded and has been drawn by a registered surveyor. Name of Mine and/or Pit Permit No. Permitted Land Use Affected Acreage Location (Sec., Twp., Range, Co.) Acres Row Crop Acres Pasture-Hay Acres Rangeland Acres Forest Acres Other Total Acres That the foregoing statement is true and correct to the best of my knowledge. .

Signed Title Date

. . .