PERMFILE42417

• Permit No: M1981286
• IBM Index Class Name: Permit File
• Doc Name: LIMITED IMPACT 110 AND SPECIAL TEN DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

- s ,~ _ ~ ~
110 ?e-!: :aoLi:Jt!Jn ~c ~r.:'d)
I:;ST3CCS:0';5: :his appllcad en Jnd all aaomoaryia¢ -~acerl als must he iu :.~nicted in
du?licace. h tic SncerxSCS of ~:__ _aac orr,,;assina, - c - _xlcdx
J for ;uidanee; Special 10-day ?eraics, see 2ULF. + for ;u i~ianee.^-
?^C:1'~3IS A - _ezal ]eser'_~tion
She '_e3a1 description mwt LdentL'y the af_`eeced Land and ba •.rholly adequ.ace for ?ie'_d
Location of the property. Ic can Sa La the Eom of sscea 6 bounds suc-~ey or ; descrip-
c'_oa by reference co township, range, and section, co a[ least chn nearest quarter-
quartar section. +rere applicable, [ha street address ar Ioc number(s) rsy be used.
~~..3L32S 9 -'!1aiaR ??an
This ^,^ be a general discussion of the sethoda, agn'_pmeat, phases or stages of the
aperatioa sad chase portions of Land affected by each. She ?lan should S.e correlated
vich chn map sad should shay •rhera escaedon will begin, sad vhieh ~iireccinn, if say,
it x'.11 proceed.
_TiiI3R C - van
Shis map should clearly defies parait bauadasina sad iadieate all roads or stockpile
arena co ba used is eonnee:ioa with rho operation. All ismeddacely adjacent laadowers
rust ba shas+n. She quarter section corner, saeriaa line, or any ocher Locaceable
ooiacs should also ba show on this Sap.
t_C?*9L~ 0 - ':Lld1!'_a. ~atxr Resources. Cea;etat'_on and Soils Inforaation
°_aeh of chn above-naneiaaed aahjeeu mss[ be addressed as oucliaad is chn applieabl•
3IILE.
°_T9I3?? ? - Rec'_aapaY on P~aa
as virh toe .,i n1n; ?lea, this should ba a general discussion pf chn 3echods, equi?mear,
phases or stages of the reclamation process sad chose por:'_ons of Land af:ected by seta.
If passible, tae ?lea should ba closely eor-__elaced vich the sap. Lf :.o c, the aar_ative "
gust Sa comorehensiva xaough cp dray as accurate verbal picrare of the espeeted appear-
ance of Cae area after cvmalatioa of reclanation.
~?r3I'_ F - ?rpaE of '.Heal Caver:meat apnraval
Shis misC be a 1ae:er from ran Loea1 goverment apeeif7la; caafJraaaca rlch e~s[ia;
ranLg regulacicm . (It is iacended that operators say abcaia ioeal gover~enc apnrooal
cancer-.sac :=:5 the 01•rision's ?roeessing of cSa app licadon. '•o do ;o, tae operator
Est submit evidence vhieh iadieatea that Loesl ;overament aporaval s cnr_en[ly ?eadia;
or vL"_ at lease ba eansldered wicaia a reasonably short ties by the appropriate govern-
izg body 3CI_ l.l(10) (Cansulc phis 3GI.2 for ful'_ details oa this requirsxane.)
.??3 L' - Source of Lazal Rixat co later
:hie conk be a copy of :he'lease, deed, abstract of cit'_e, or cur-_ent tas :eeaipc.
as acceptable aicernauve vau'-d 6e a stat~seac se~avledged Sy a aotar7 public chat
tae operator has toe legal :ighc Co eater sad sine.
-_I ST3r ?1 - Raala=aCian Cpara
For a 1-'0 ?erai:, ii she operator requests suncy tp be 1x99 Casa 52500, :he ooeratortsmt
submit fact; to support sots a reeuesc. Other•.rise, a sursc7 of SSSCO vili autJ.:.acically
Se Sat. cot all '-iI per>.its, G4e sursc7 shat' ba SZ500 per acre.
'.?.3I. I - a:~ of Coveraental Gut-acts
For Spetiai 10-lay (111) Peraies, tea operator moat submit a copy of the cont. set or
ocher 7ropf chat proves the necessity of a special 10-day permit. T.he ooeratar moat
also submit evidence a2 the sursc7 provided wader the gocerr=.natal eont:act, 1f is ~aa
required.
YOTLC'L ?ROC~UR:S
after chn apalicacipn is consldersd "?ilad" (pursuant co 211L 1.1(LO) with the Yiaed
Land Reclamaclen Oivislan, notice procedures outlined is RLtiS 1.2 sad/oc 4.2 must be
followed. (Fp sae for such ao N-tea vL'1 be ineiuded is chn litter you receive Eram tae
`II3 Staff ia=ar..iag you of the eoe:o laeeness ("filir.;") of your applicacipn.
,t~nl-.:c,L,u. *_.vFCRaa::ax
:his snaee can be referenced for further !aforaation of any of the items on c.41s fora.
SJ the lest of s? taovledge, al'_ tae Laforaa _ prose d in - nplicaciaa is rue
and nor-.set.
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