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;4. Present land use (i.e., agrt- Gravel pit and wildlife habitat cultural, dnd ust real, etc.) 15. Propos.:d future land psc Gravel pit and wildlife habitat (Goal of reclamation) It15T RUCTIONS: This application and all accompanying mterials must Sz submi CCed in duplicate. In [lie in[e rests of efficient ~p rocessin?, please includz [hz following inforaa- ttpn G items. ~ Limited impact Operations, see RULE ) for guidance; SFecial 10- day 7e rnits, see RULE 4 for guidance. E%HIB IT A - Local Description The Izgal description oust identify the affected land and be wholly adequate for field location of [he prepe rty. I[ can be in [he form of metes E bounds survey or a des r. rin[ionby reference to [ewnsh ip, range, and section, to a[ least [he nearest quarter-G ua rter section. Where applicable, [he street address or lo[ number(s) may 6e used. F %H181T B - Mining Plan This can be a ce ne ral discussion of the methods, equipment, phases or stages of the operation and [F.e se po riions of land affected by each. The plan should be . correlated with [hz map and should show where ex2 racti on will begin, and which dl rection, If any, it will proceed. EXHIBIT C - Map This map should clearly define permit boundaries and indicate all roads or stockpile areas [0 6e used in connac[ion with [he operation. A)I irmedia[ely adjacent landowners must be shown. The ypdf :ef section corner, section line, oc~any other iota [ea61e points should also be shown on [his map. E%H IB IT D - 4ildlife, '+'a tzr Resources, Vegztati on and Soils Infor ma [i on Each of the above-mentioned subjects must be addressed as outlined in the applicable ~ ~ . RULE. EXHIBIT E - Recl?m~iion Plan As with the mining plan, this should be a general discussion of the methods, equi'rrent, phases or stages of the reclamation process and Those portions of land affected Sy each. If possible, the plan should be closely correlated with [he map. IF not, the n:. r-a[ive must be comprehensive aneugh [o draw an accurate verbal picture of the expected appear- ance of [he area of ter completion of reclamation.. E%H101T f - Prcof of Local Government Aop royal This :oust be a letter fran [he local government specifying conformance wi [h existing zoning reg ulaticns. (I[ is intended [hat operator; :nay obtain local yove rn^ent approval concurrent with the Division's processing of [he application. To do so, the ope ra [or must submit evidence which indicates that local govt. approval is currently ?ending or will at least Se~conside red within a reasonably short time by [he appropriate • governing body. .RULE I.1 (10) (Consul[ this RULE for full details on Chis requirement.) E%HIBIT G - Sou rte of !coal Rich[ [o Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. fn accep L: ble a:tc rnuive would 6z a statement acknowledged by a notary public that the operator has the legal right to enter and mine. E %H IBIT H - Recl amaiion Cos [s If the surety is requested :o be less than $2500, [he ope rotor :,lust submit facts to suppo r[ such a request. O[he rwise, a surety of 52500 will automati tally be se [. *** FOR SPECIAL 10-DAY (111) PERMITS OtILY "* EXHIBIT 1 - Terms of Cove rnnrv: ntal Contract For Special 10-Coy (Ill) Permits, the ope raior must submit a copy of the contract or other proof that proves the necessity of a special 10-day pe r-!i [. The operator must also submit evidence of the surety provided under the yove rnmencal contract, if it was requl red. ~ - t10TICE PROCEDURES After the apPl icati on is considered "filed" (pursuant to ..°.ULE 1.1(10) with the Mined Land Rccl ama[io•l Division, notice procedures outlined in RULES 3.2 c/or 4.2 must 6e followed. (Forma[ for such notices will be included in the lett^_r you receive from thz ftLR staff informing you of the completeness ("filing") of your application. ADDIT 1011AL INFO P,HATI CN This space can Se referenced for further info rmation of any of [he hens on this fore. • To [he best of my kncwledg•:, all [he in fo rna[ion Frzsen [ed in his applicu ti on is °r u~ and co rrzc[. ~~ 7 ~ DY y ~p: .rte. ci^,: / :~ '~' i l~~;ned cy ~6nivi ual legally author- .. _ i. ed tp 6i r.d [he.ope rotor [o :his lppli ta[i On.)