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<br />-- • • ` <br />Tll6 OR PRINT CLEARLY <br />'" 14. Prasaat load wa p,Qr;c~ ,ral a.,r; n~o <br />(i.a., agrieultuzal, ladustrial, •te.) <br />15. Propoud tutasa land wa RBCIa;m as close ac mcc; le to oricrinal <br />(Coal of raelaaation) state. (Agriculture) <br />INSTRUCTIONS: This application fort suet ba submitted in duplicae• and each form moat <br />be accos~paniad by the folloriag information and items. The application <br />rill oot be processed uatil complete. See RULE 3 (for Limited Impact) <br />or RITLt{ < (fos Spatial 10-day) !or additiovel guidance. <br />E701IBIT A - Legal Description <br />iha legal daaeriptioa seat ldaatify,ebs affactnd land sad be vholly adegwta fos <br />field loeatioo of the peopasty. It esa ba Sa cha fora of metes and bounds aurvq <br />os a dascslptlon b7 rsfaraots to toraship, Tanga, and section to at laaat cha <br />naarut gwrtar quarter section. Hhasa applicable, the atzaat addrea• or lot <br />nuobsr(s) arty ba used. ' <br />E7CHIBIT D - MSninR Plan <br />This can ba a gaveral discussion o! the mechode, equipment, phases or stages of <br />the operation and [hose portions of land affected by each. Tha plan should ba <br />,~ closely corralactd with the sap and should ehov vhern extraction will begin, vhieh <br />direction it will proceed. <br />,v <br />E'ffiIBIT C - Map <br />V <br />This map should ba as coa~prahenaiva as possible is terms of clearly dafiaiag <br />the permit bowdariaa sad iadieatiag all roads or stocicpila areas to b• used !a <br />convection with the operation. All Saedia[nly ad]acent landovnars moat b• show. <br />The eloaaat gwstar section coraar, section line, or any other Loeateable point <br />should also ba show oa the sap. <br />c.~IIBIT D - Wildlife, Water Raaourees, Vagatatioa end Soils Lnformation <br />Each of CM above-santioned sab~aets ever be addrea sad as outlined in the <br />ipplicabl• Kula, under Stem weber tan (10). <br />EOIIBIT E - Raclaaatioa Plaa <br />A. vith the mlaiag plea. this should ba a geaeral diseuaalon of the methods, <br />equiparat, phases or •tagu of the raelsmation procssa and those portions of <br />lead atfaetad by each. It poasibla, the plan should ba eloaaly correlated <br />rith the map. It not. the narrative must ba comprehensive eaough to dray as <br />aecurat• verbal picture of the azpaetad physical appearaae• of the area attar <br />eonplation of reclamation. <br />ESAIDIT F - Ptoot of Local Covarwent Approval <br />This must b• a lattaT isoa cha local government specifying eonformaaca with <br />,, azisting soning regulations. <br />E~3IBIT G - Soure• of Legal Right to Enter <br />This could ba a copy o! the laaaa, dead, abstract of title, or current tax <br />raesipt. Ia lieu thereof, a statamaac aeloaovledged by a notary public that <br />cha operator has the 1aµ1 right to solar sad mina will ba aceaptsd. <br />""FOR SPECIAL. 10-DLL! PER4IITS 0lQ.TM <br />E7QLIDIT H - Raelaaation Coats <br />If the surety sa ragwstad to ba las• than S2500, the operator must aubait <br />lotto to support loch request. Otharvise a surety of $2500 will automatically <br />ba eat. <br />E)OiIDIT I - Tares of Covarnsrntal Coatract <br />Tha operator swat aubait a copy of the contract or other proof chat proves the <br />aacasaity of a spacial 10-da7 permit. The operator moat also •ubmic evldeace <br />of th• surety provided under the governmental contract, if S[ vas required. <br />