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14. Present la J use (i.e., agrl- G enltu ral, ndustrial, etc.) IS. Proposed f cure land use Grassland (Goal of r clamacion) INSTRUCTIONS: is appllca tlon and all accmpanyinq materials must be submi teed in duplicate. In the interests of efficient ~processlnq, pleasn Include the fo 4l wlnq infor:ra- lan a iterx. L(~ited )coact OPeratlons, sea RULE ) for guidance; SDeci al 10- ay Permits, sa AULE 4 for guidance. EXNIB IT A - Le 1 Descri orlon The legal descr ptlon oust Identify the affected land and be wholly adequate far. fl old loutian f the property. It can be In [he fora of meter L hounds survey or a descr) ptl by reference to tomsh tp, range, and section, to •c least the nearest quarter wrier section. Vhern applicable, the street edd rest or lot number(s) may used. EXHIBIT B - Min n Plsn This can he a g ne ral discussion of [he methods, equipment, phases or stages ol` [he operation and t ose portions of land affected by each. The plan should be Correlated with the map and should show where extraction will begin, 'and which dl rection, If a y, It will proceed. EIUi181T C - Ma This map should clearly define permit boundaries and indicate all roads or stockpile areas to 6e use in connection with the ope ra[ion.~ All imaediately adjacent landowners must be shoran, The quarter sec ti an corner, section line, ar•any other locateable points should also be hown an this map. EXHIBIT 0 - Vil life tie ter Resources Ve etati on and Soils Information Each of the orb a-men ci oned subjects must be addressed as outlined in the applira6la RULE. EXMIBI7 E - 0.e )emotion Plan . ~ ~ ~ -.. As with [he ml tog plan, to is sitouiu L~ a.g.::~ral discus si on of the methods, equipnn[, phases or stag s of the reclamation process end those portions of land of fecced by each. If oossible, C e plan should be cl usely correlated with [he map. If not, the narrative - must be compre ensive enough to draw an accu ra [e verbal p; cture of the a:petted appear- ance of the ar a after campleti on of reclamation. EXHIBIT F - Pr of of local Government Approval ,This must be a letter from thn local government specifying conformance with exi sting~ zan ing regale[ ons. (I[ is intended Chat operators may obtain local gove rumen[ approval wncurren[ wit the Oi vi si0n's processing of the application. To do so, the operator anrst submit ev dente which indicates [hoc local govt. approval is currently Pending or will at lea t be considered w; ch in • reasonably short time by the apprppri ate gove rninq body .RULE 1.1(10) (Consult this RULE for full details on this requ; rement.) EXHIBIT ~G - So rte of Leeal Ri phi to Enter This mould be copy of the lease, deed, abstract of tl tie, or current tax receipt. An aecZp[able alte rna [i ve would be a statement acknowledged by ~ notary public that the operator h s the legal nigh[ [o enter and mine. EXH 1817 H - 0.e lamaci on cos [s If the surety s reques ced to be Tess than 52500, the oae rotor must submit facts to support such a request. Otherwise, a surety of $2j00 will automatically 6e set. •*• FOR SPECIAL 10-DAY (111) PE0.MIT5 ONLY ='- EXHIBIT 1 - Te ms of Gove rnruneal Contract `~ For Special 10 Day (1 il) Permits, the operator must submit a copy of the contract or other proof [h t proves ;he necessity pf r cpeci al 10-day.per~it.. The operator must •Iso submit ev idence of the surety provided under ~[he governmental contract, if IC was ~ requ(red. ~ ~ ~ ~ , ' lIOTICE PROCEDURES - AF[er the app icatf on is considered "filed" (pursuant to RULE 1.1(10) with [he Mined land Reclamation 0 vision, notice procedures outlined in RULES j.2 a/er 4.2 must be followed. (Format for s ch notices w; 11 be included in the letter you receive frcm the MLR staff Informing you of the co~Ple[eness ("filing") of your appllca [i on. - AOOI710tIAl INF00.tUTI ON ' This space ca 6e referenced for further information of any of the items on this form. To the best o a''/ kncwl edge, all [ha In forma to oi+ pre :en ced in this appllca [lo is true and correct. i BY TITLE [~ • ( igned oy ind'v~ ual legally auclor- ' Iced [o bind [he opr.ra for to this