2024-03-19_PERMIT FILE - M2023027

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-4- 1 2 Primary_future(Post-mining)land use(chec i 1 •): _ Cropland(CR) iOA Pastureland(PL) General Agriculture(GA) Rangeland(RL) . Forestry(FR) 7 Wildlife Habitat(WL) Residential(RS) ' Recreation(RC) IndustriaUCommercial(IC) Developed Water Resources(WR) Solid Waste Disposal(WD) 13. Prim' resent land use(check one): Cropland(CR) t Pastureland(PL) _ General Agriculture(GA) 1 El Rangeland(RL) I Forestry(FR) Wildlife Habitat(WL) El Residential(RS) Industrial/Commercial(IC)Developed Water Resources(WR) , Mining(MN) 14. If this operation will use designated chemicals,or will result,or presently has acid mine drainage-you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case,you must list any acidic or toxic-forming materials,exposed or disturbed as a result of the mining operation,and whether the operation will result in or presently has acid mine drainage: N/A- 15. Description of Amendment or Conversion: If you are am/eenndixtg or converting an existing operation,provide a brief narrative describing the proposed change(s): /� f//4-- Maps & Exhibits: Submit two(2)complete,unbound copies of the following application exhibits: 6.3.1 EXHIBIT A -Legal Description and Location Map 6.3.2 EXHIBIT B - Site Description 6.3.3 EXHIBIT C -Mining Plan 6.3.4 EXHIBIT D -Reclamation Plan 6.3.5 EXHIBIT E-Maps,to include the location of any recorded easements 6.3.6 EXHIBIT F- List of Other Permits and Licenses Required 6.3.7 EXHIBIT G - Source of Legal Right-to-Enter 6.3.8 EXHIBIT H -Municipalities Within a Two-mile Radius 6.3.9 EXHIBIT I-Proof of Filing with County Clerk 6.3.10 EXHIBIT J-Proof of Mailing Notices of Permit Application 6.3.12 EXHIBIT L-Permanent Man-Made Structures 1.6.2(1)(b) ADDENDUM 1 -Notice Requirements(sample enclosed) 6.5 Geotechnical Stability Exhibit(as required)