PERMFILE47357

• Permit No: M2001063
• IBM Index Class Name: Permit File
• Doc Date: 6/22/2001
• Doc Name: LIMITED IMPACT OPERATION 110 2 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

-3-
11
Primary fu ure (Post-mining) land uae (check one):

_ Cropland(CR) _ Pastureland(PL) _ General Agriculture (GA)
Rangeland(RL) ]~ Forestry(FR) _ Wildlife Habitat (WL)
Residential (RS) _ Recreation(RC) _ Industrial jCom¢nercial (IC)
Developed Water Resources(WR) _ Solid Watte Disposal(WD)
12
Primary present land use (check one):
Cropland(CR) ~ Pastureland(PL) _ General Agri culture (GA)
_ Rangeland(RL1 X Forestry(FR) _ Wildlife Habitat(WL)
_ Residential(RS) _ Recreation(RC) _ Industrial/Commercial(IC)
Developed water Resources (WR) _ Mining (MN)
13. If this operation will use designated chemicals, or will result, or
presently has acid mine drainage - you cannot use this application
form. You must submit a either a 110d or 112d application form for
Designated Mining Operations. In either case, you must list any
acidic or toxic-forming materials, exposed or disturbed as a result of
the mining operation, and whether the operation will result in or
presently has acid mine drainage:
No acid mine drainage Water sample tests included herewith.
Description of Amendment or Conversion:
If you are amending or converting an existing operation, provide a brief
narrative describing the proposed change(s).
Maps & Exhibits•
Submit TWO (2) complete, unbound copies of the following application
exhibits:
6.3.1
6.3.2
6.3.3
6.3.4
6.3.5
6.3.6
6.3.7
6.3.8
6.3.9
6.3.10
6.1.2 (1) (b)
6.4.19
6.5
EXHIBIT A - Legal Description and Location Map
EXHIBIT B - Site Description
EXHIBIT C - Mining Plan
EXHIBIT D - Reclamation Plan
EXHIBIT E - Maps
EXHIBIT F - List of Other Permits and Licenses Required
EXHIBIT G - Source of Legal Right-to-Enter
EXHIBIT H - Municipalities Within a Two-mile Radius
EXHIBIT I - Proof of Filing with County Clerk
EXHIBIT J - Proof of Mailing Notices of Permit Application
ADDENDUM 1 - Notice Requirements (sample enclosed)
EXHIBIT S - (as required)
Geotechnical Stability Exhibit (as required)