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. ~ • <br />.. . <br />TYPE OR PRINT CLEARLY <br />14. Present land use Agriculture - Grazing land <br />(i.e., agricultural, industrial, etc.) <br />15. Proposed future land use Same <br />(Goal of reclamation) <br />IDTSTRUCTIONS:' This application form must be submitted in duplicate and each form must <br />be accompanied by the following information and items. The application <br />will not be processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional guidance. <br />E7t$IBIT A - Legal Description <br />The legal description must identify the affected land and be wholly adequate for <br />field Location of the property. It can be in the form of metes sad bounds survey <br />or a description by reference to township, range, and section to at least the <br />nearest quarter quarter section. Wherc applicable, the street address ar lot <br />number(s) may be used. <br />E7~IBIT B - Miniast Plaa <br />Thin can be a general discussion of the methods, equipment, phases or stages of <br />the operation and those portions of land affected by each. Tha plan should be <br />closely correlated with the map and should show where extraction will begin, which <br />direction it will proceed. <br />EffiIBIT C - Maw <br />This map should be as comprehensive as possible in terns of clearly defining <br />the permit boundaries and indicating all roads or stoclcplle areas to be use¢ in <br />connection with the operation. All imsaediately adjacent landowners must be shown. <br />The closest quarter section corner, section line, or any other locateable point <br />should also be shown on the map. <br />ERHIBIT D - Wildlife, Water Resources, Vegetation and Soils Information <br />Each of the above-mentioned subjects moat be addressed as outlined in the <br />applicable Rule, under item number ten (10). <br />E~IBIT E - Reclamation Plan <br />As with the mining plan, this should be a general discussion of the methods, <br />equipment, phases or stages of the reclamation process and those portions of <br />load affected by each. If possible, the plan should be closely correlated <br />with the map. If nap, the narrative must be comprehensive enough to dray an <br />accurate verbal picture of the expected physical. anpearauce of the area after <br />completion of reclamation. <br />E~IBIT F - Proof of Local Government Approval <br />This must ba a letter from the l~..al gay+e~.~sarit ype::it%iag cuufor~nce with <br />existing zoning regulations. <br />ERBIBIT G - Source of Legal Ritit:t to E.:te: <br />Thin could be a copy of c't:e lease ae.d, dhac:_cc at i.?.e!e, ur c,..,.~e~t cdx <br />receipt. III lien [hereof, a st: c:a]~nt a~•rt;::;u; ~++ga.: ~:y :. n~;ca:y publlti. :::aC <br />the operator has the legal :igtt ~o enter azid nine .il! ue accepccd. <br />**FOR SPECIAL 10-DAY PER`iITS 0*ILYxa <br />E~IBIT H - Reclamation Costs <br />If the surety is requested to be less titan S3500, the operator must submit <br />facts to support such request. Other.rise a surety of 52570 will. auto~aaci,;ally <br />be set. <br />~IBIT I - Terms of Governmental Contract <br />The operator must submit a copy of the contract or ocher proof Chet proves the <br />necessity of a special 10-daq permit. The operator must also submit evidence <br />of the surety provided under c`e governmental contract, if it was required. <br /> <br />