Form DMM-103 "Notice of Application to Mine" - Virginia

What Is Form DMM-103?

This is a legal form that was released by the Virginia Department of Mines, Minerals and Energy - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2016;
  • The latest edition provided by the Virginia Department of Mines, Minerals and Energy;
  • 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 DMM-103 by clicking the link below or browse more documents and templates provided by the Virginia Department of Mines, Minerals and Energy.

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DIVISION OF MINERAL MINING
900 NATURAL RESOURCES DRIVE, STE 400
CHARLOTTESVILLE, VA 22903
(434) 951-6310
NOTICE OF APPLICATION TO MINE
NOTICE ISSUED BY
APPLICANT'S NAME
ADDRESS
TELEPHONE NO.
NOTICE ISSUED TO PROPERTY OWNERS WITHIN 1000 FEET OF PERMIT BOUNDARY:
Name
Address
State law (Section 45.1-184.1 of the Code of Virginia) requires that land owners within 1,000
feet of a proposed new mineral mine be notified that the operator is seeking a surface mining and
reclamation permit from the Department of Mines, Minerals and Energy. The surface mining
permit must address Department of Mines, Minerals and Energy requirements for regrading,
revegetation and erosion controls of mineral mine sites.
In accordance with that requirement
(COMPANY NAME) is hereby notifying you that it has applied/will apply for a surface mining
and reclamation permit on
(DATE). The mineral to be mined is
. The proposed mine is located
miles
(DIRECTION)
of
(NEAREST TOWN) on
(ROAD)
in
(CITY/COUNTY), Tax Map ID No.
.
Property owners within 1,000 feet of the land proposed to be mined for minerals other than
coal may specify objections in writing and request a hearing within ten (10) days of receipt of this
notice to: The Department of Mines, Minerals and Energy, Division of Mineral Mining, 900
Natural Resources Drive, Suite 400, Charlottesville, Virginia 22903, (434) 951-6310.
DMM-103
Rev 05/16
DIVISION OF MINERAL MINING
900 NATURAL RESOURCES DRIVE, STE 400
CHARLOTTESVILLE, VA 22903
(434) 951-6310
NOTICE OF APPLICATION TO MINE
NOTICE ISSUED BY
APPLICANT'S NAME
ADDRESS
TELEPHONE NO.
NOTICE ISSUED TO PROPERTY OWNERS WITHIN 1000 FEET OF PERMIT BOUNDARY:
Name
Address
State law (Section 45.1-184.1 of the Code of Virginia) requires that land owners within 1,000
feet of a proposed new mineral mine be notified that the operator is seeking a surface mining and
reclamation permit from the Department of Mines, Minerals and Energy. The surface mining
permit must address Department of Mines, Minerals and Energy requirements for regrading,
revegetation and erosion controls of mineral mine sites.
In accordance with that requirement
(COMPANY NAME) is hereby notifying you that it has applied/will apply for a surface mining
and reclamation permit on
(DATE). The mineral to be mined is
. The proposed mine is located
miles
(DIRECTION)
of
(NEAREST TOWN) on
(ROAD)
in
(CITY/COUNTY), Tax Map ID No.
.
Property owners within 1,000 feet of the land proposed to be mined for minerals other than
coal may specify objections in writing and request a hearing within ten (10) days of receipt of this
notice to: The Department of Mines, Minerals and Energy, Division of Mineral Mining, 900
Natural Resources Drive, Suite 400, Charlottesville, Virginia 22903, (434) 951-6310.
DMM-103
Rev 05/16
STATEMENT LISTING THE NAMES AND ADDRESSES OF ADJOINING PROPERTY OWNERS
Pursuant to the provisions of Section 45.1-184.1, Code of Virginia, as amended, the owner(s) of
property within 1,000 feet of the property line of the land proposed to be permitted are listed below:
NAME
ADDRESS
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
If additional space is needed, continue list on back of sheet.
The above statement shall accompany form DMM-101, Permit/License Application. Attach return
receipt(s) for certified mail as evidence that each of the above property owner(s) has been notified.
DMM-103
Rev 05/16
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