Form MRD-7 "Application for Transfer of Permit" - Mississippi

What Is Form MRD-7?

This is a legal form that was released by the Mississippi Department of Environmental Quality - a government authority operating within Mississippi. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2004;
  • The latest edition provided by the Mississippi Department of Environmental Quality;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form MRD-7 by clicking the link below or browse more documents and templates provided by the Mississippi Department of Environmental Quality.

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Download Form MRD-7 "Application for Transfer of Permit" - Mississippi

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MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY
OFFICE OF GEOLOGY
Mining and Reclamation Division
P. O. Box 2279
Application
Jackson, Mississippi 39225-2279
Permit Number
Number
(601) 961-5515
(For Office use only)
(For Office use only)
APPLICATION FOR TRANSFER OF PERMIT
I.
Name of original Applicant (or current operator) _____________________________________________
Name of mining operation _______________________________________________________________
Permanent mailing address _______________________________________________________________
Telephone number including area code _____________________________________________________
II.
Name of Applicant (New) _______________________________________________________________
Name of mining operation _______________________________________________________________
Permanent mailing address ______________________________________________________________
Telephone number including area code _____________________________________________________
III.
Engineering Firm, Consultant, etc. (if applicable) (new applicant)
Name ________________________________________________________________________________
Address ______________________________________________________________________________
Telephone number including area code __________________________________
IV.
Has the applicant applied for or held any other permits or licenses that pertain to this or any other mining
operation? Attach additional pages as required.
‫ٱ‬
‫ٱ‬
Yes
No
If “yes,” list them in the space provided below and give current status of each.
______________________________________________________________________________________
______________________________________________________________________________________
Application for Transfer of Permit must include:
CERTIFICATE OF INSURANCE: Must indicate that the applicant has sufficient liability insurance in
1.
an amount not less than $100,000/300,000 for Bodily Injury and $100,000 for Property Damage.
2. PERFORMANCE BOND: Must be at least $1000/acre and not more than $2500/acre and is based on
the applicant’s estimate of the reclamation cost. The “TOTAL PERMITTED AREA” in A-7, page 1, is
the number of acres to be bonded. A Certificate of Deposit may be substituted.
3. PROOF OF THE APPLICANT’S LEGAL RIGHT TO MINE: A lease, deed, or agreement that
includes a legal description of the permit area. This includes city or county approval, if applicable.
This must be notarized.
4. COMPLETED ORGANIZATION REPORT FORM MRD-1.
Form MRD-7
rev. 03/04
MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY
OFFICE OF GEOLOGY
Mining and Reclamation Division
P. O. Box 2279
Application
Jackson, Mississippi 39225-2279
Permit Number
Number
(601) 961-5515
(For Office use only)
(For Office use only)
APPLICATION FOR TRANSFER OF PERMIT
I.
Name of original Applicant (or current operator) _____________________________________________
Name of mining operation _______________________________________________________________
Permanent mailing address _______________________________________________________________
Telephone number including area code _____________________________________________________
II.
Name of Applicant (New) _______________________________________________________________
Name of mining operation _______________________________________________________________
Permanent mailing address ______________________________________________________________
Telephone number including area code _____________________________________________________
III.
Engineering Firm, Consultant, etc. (if applicable) (new applicant)
Name ________________________________________________________________________________
Address ______________________________________________________________________________
Telephone number including area code __________________________________
IV.
Has the applicant applied for or held any other permits or licenses that pertain to this or any other mining
operation? Attach additional pages as required.
‫ٱ‬
‫ٱ‬
Yes
No
If “yes,” list them in the space provided below and give current status of each.
______________________________________________________________________________________
______________________________________________________________________________________
Application for Transfer of Permit must include:
CERTIFICATE OF INSURANCE: Must indicate that the applicant has sufficient liability insurance in
1.
an amount not less than $100,000/300,000 for Bodily Injury and $100,000 for Property Damage.
2. PERFORMANCE BOND: Must be at least $1000/acre and not more than $2500/acre and is based on
the applicant’s estimate of the reclamation cost. The “TOTAL PERMITTED AREA” in A-7, page 1, is
the number of acres to be bonded. A Certificate of Deposit may be substituted.
3. PROOF OF THE APPLICANT’S LEGAL RIGHT TO MINE: A lease, deed, or agreement that
includes a legal description of the permit area. This includes city or county approval, if applicable.
This must be notarized.
4. COMPLETED ORGANIZATION REPORT FORM MRD-1.
Form MRD-7
rev. 03/04
I declare that I have knowledge of the facts presented in this Application for Transfer of Permit and in Surface
Mining Permit No. ___________ and in all the items attached to this application; that I will follow and abide by the
Reclamation Plan in the original surface mining permit; furthermore, I certify that the information contained herein
is true to the best of my knowledge.
Date _________________________________
_________________________________________
Signature
_________________________________________
Printed Name
_________________________________________
Title
Form MRD-7, Page 2
rev. 03/04
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