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110 Permit Appll cation (con t'd.) 14. Present land use (i.e., agri- 'i-,~,~.'~~~~ -,'i /,,~•//~. cultural, industrial, etc.) I5. Proposed future land use It.~/?n~r.~'Tf/ /~l~l/n~~ (Goal of reclamation) ,,, ~ ~ _- _ ~, ~, INSTRUCTIONS: This application end all accompanying materials must be submitted In dupllcaur. In [he Inte res is of efflcfent process ing;~plnase Include the fallowing Informa- tion 6 Items. Limited Impact Operations, sea RULE 3 for guidance; Spa:i al 10- day Permits, see RULE 4 for guidance. EXHIBIT A - Legal Desc ri p[ion The Ieg~rl de scrlDtion must Identify the affected land and be wholly adequate for (l eld location of [he prnpe,':r. It --: yc '.' the °^'~ ^O Totes L hounds avrvev or a der criptlon by reference to townsh ip,~range, and section, to at least the nearest quarter-quarter section. Where applica bls, the street address or lot number(et) may' be used. EXHIBIT 8 - Mlninp Plan This can be a general discussion of the methods, equipment, phases or stages of the operation and those portions of land affected by each. The plan should be co rrelaced with the map and should show where extraction will begin, and which di rectlnn, if any, it will proceed. E%HIBIT C - MaP This map should clearly define permit bounds rles and Indicate all hoads or scockplle areas to be used in connection with the operation. Ail Immediately adjacent landowners must be shown. The quarter section corner, section line, or any other loca [cable points should also be shown on this map. EXHIBIT D - Wildlife, Mater Resources, Vege tart on and Soils Information Each of [he above-mentioned subjects must be addressed as outlined In the applicable RULE. EXHIBIT E - Reclamation Plan As wl th the mining plan, this should be a y~n~~e: dfscm sicr. cr -- `-di, r, _!,^^-^.!, phases or stages of the reclamation process and those portions ofLland affected by each. If poss llble, the plan should be closely correlated with the map. If not, the narrative must be comprehensive enough LO draw an accurate verbal picture of the expected appear- ance of the area after completion of reclamation. EXHIBIT F - Proof of local Government Aop royal This must be a letter from the local government specifying conformance with existing zoning ngulatlons. (!' is Int-.^.ded [ha[ ope rar ors may obtain local gove roman[ approval concur Went with the Division's processing of the aDDi ication. To do so, the operator mus: submit evidence w.`.!c.`. !c~lcstes that loc*1 Wove. approval is currently pending or will at least be considered within a reasonably short time by the appropriate oov-ruing body. .RULE 1.1(10) (Consult this RULE for full details on this requirement.) EXH!B IT G - Source of L!nal Al~aht to Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. An acceptable alternative would be a statement acknowledged by a notary public chat the operator has the legal rlpht to enter and mine. EXHIBIT H - Reclamation Costs If the surety is requested to be less than 52500, the operator must submit facts to ~~~ support such a request. Otherwise, a surety of 52500 will automatically be se [. •i• FOR SPECIAL 10-DAY (111) PERMITS ONLY +'+• EXHIBIT I - Terms of Governmental Contract for Special 10-Day (111) Permits, the operator must submit a copy of the contract or other proof that proves the necessity of a special 10-day permit. The operator must also submit evidence of the surety provided under the governmental contract, If it was required. NOTICE PROCEDURES After the application is considered "filed" (pursuant [o RULE 1.1(10) with the Mined Land Acclamation Division, notice procedures outlined in RULES 3.2 6/or 4.2 must be followed. (Format for such notices will be included in the letter you receive from [he MLR staff informing you of the completeness ("filing") of your application. ADDITIOIIAL INFORMATION To the best of my knowledge, all the In fo rmatl on presented fn this applicatl on Is true and co Tract. ~% Si ed by divid le y author- LL k% ~~/~~""~~~ TITLE - g // ~ 1 ed [o Ind the pe rat So this / application.) This space can be referenced for further information of any of the items on this form.