PERMFILE45221

• Permit No: M2001022
• IBM Index Class Name: Permit File
• Doc Date: 3/20/2001
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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I5. Descriotioo of Amendment or Conversion:
If you are amwdiug or converting an existing operation, provide a brief narrative describing the proposed change(s).
N/A
Mans and E~ibits:
Five (5) complete, unbound application packages must be submitted. O¢e complete application package consists of a signed application foam
and the set of maps and exhibizs referenced below as Exhibits A-S, Addendum 1, and the Geotechnical Stability Exhibit. Each exhibit within
the application must be presented as a separate sectio¢. Begin each exhibit on a new page. Pages should be numbered consecutivety for ease
of reference. If separate documents are used as appendices, please reference these by mme in the exhibit.
Wittt each of the five (5) signed application forms, you must submit a corresponding set of the maps and exhibits as described is the following
references to Rule 6.4, 6.5, and 1.6.2(I)(b):
EXl-IIBIT A Legal Description
EXHIDIT $ Index Map
EXI-IIBIT C Pre-Mining and Mining Plan Map(s) of Affected Lands to include the location of any recorded easements
EXI-IIBIT D Mining Plen
E3CHIBIT E Reclamation Plan
E}CFIIBIT F Reclamation Plan Map
EXFIIDIT G Wnter Information
EXFIIBIT H Wildlife Wormation
EXI-IIBIT I Soils Information
EXIIIBIT J Vegetation Information
EXI-IIBIT K Climate ]nfotmation
EXI-IIBIT L Reclamation Costs
E}CHIBIT M Other Permits and Licenses
E7CHIDIT N Source of Legal Right-To-Enter, to include holders of any recorded easements
EXIrIIIBIT O Owners of Record of Affected Lmd (Surface Area) and Owners of Substance to be Mined, to include
holders of any recorded easements
EXI-IIBIT P Municipalities Within Two Miles
E}CHIBIT.Q Proof of Mailing of Notices to County Commissioners and Soil Conservation District
EXI-IIBIT R Proof of Filing with Co®ty Clerk or Recorder
EXfflBff S Pemrauent Man-Made Stroctures
Rule 1.6.2(1)(b) ADDENDUM 1 -Notice Requirements (sample enclosed)
Rule 6.5 l reo[echnical Stability Exhibit (any required sections)
The instructions for preparing Exhibits A-S, Addendum I, and Geotechnical Stability Exhibit ate specified under Rule 6.4 end 6.5 and Rule
1.6.2(1)(b) of the Rules and Regulations. If you have my questions on preparing the Exhibits or content of the information required, or would
like [o schedule apre-application meeti¢g you may contact the Office at 303-866-3567.