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-4- <br /> 12. Prim ry future(Post-mining)land use check one <br /> Cropland(CR) firr✓ Pastureland(PL) E General Agriculture(GA) <br /> Rangeland(RL) I— Forestry(FR) F Wildlife Habitat(WL) <br /> Residential(RS) I_ Recreation(RC) �_ Industrial/Commercial(IC) <br /> FliDeveloped Water Resources(WR) _ Solid Waste Disposal(WD) <br /> 13. Prim resent land use check one): <br /> I— <br /> Cropland(CR) P Pastureland(PL) General Agriculture(GA) <br /> 1117 Rangeland(RL) F Forestry(FR) F Wildlife Habitat(WL) <br /> E Residential(RS) FiRecreation(RC) Industrial/Commercial(IC) <br /> EMining <br /> Developed Water Resources(WR) (1vIN) <br /> 14. Ifthis operation will use designated chemicals,or will result,or presently has acid mine drainage-you cannot use this application <br /> form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case,you must list <br /> any acidic or toxic-forming materials,exposed or disturbed as a result of the mining operation,and whether the operation will <br /> result in or presently has acid mine drainage: <br /> N/A <br /> 15. Description of Amendment or Conversion: <br /> If you are amending or converting an existing operation,provide a brief narrative describing the proposed change(s): <br /> N/A <br /> Maps c&Exhibits: <br /> Submit two (2)complete,unbound copies of the following application exhibits: <br /> 6.3.1 EXHIBIT A-Legal Description and Location Map <br /> 6.3.2 EXHIBIT B -Site Description <br /> 6.3.3 EXHIBIT C-Mining Plan <br /> 6.3.4 EXHIBIT D-Reclamation Plan <br /> 6.3.5 EXHIBIT E-Maps,to include the location of any recorded easements <br /> 6.3.6 EXHIBIT F--List of Other Permits and Licenses Required <br /> 6.3.7 EXHIBIT G-Source of Legal Right-to-Enter <br /> 6.3.8 EXHIBIT H-Municipalities Within a Two-mile Radius <br /> 6.3.9 EXHIBIT I-Proof of Filing with County Clerk <br /> 6.3.10 EXHIBIT J-Proof of Mailing Notices of Permit Application <br /> 6.3.12 EXHIBIT L-Permanent Man-Made Structures <br /> 1.6.2(1)(b) ADDENDUM 1 -Notice Requirements (sample enclosed) <br /> 6.5 Geotechnical Stability Exhibit(as required) <br />