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110 Pemic Aooliratlon lcont' • INSTRUCTIO!.S: This application and all accampnnying materials must be suhmitted in duplicate. In the ante rests or efficiant pro.:essin r„ ;.1.-asa i.;c lode [hc follovia into r...a tic: .. ..--.,. Lir..'_td r c_ C-~___, .,_. ,_- PnLE g _.pa ~_...__,...,., 3 for guidance; Special 10-day~Permlts, see RULE w for guidance.^^ ESHIBIT A - Legal Description The Legal description must identify the affected land and be wholly adequate For field location of the property. It can be in [he fora of metes b bounds survey or a descrip- tion by reference to township, range, and section, to at least the nearest quarter- quarter section. Where applicable, the street address or lot number(s) my be used. ERHIBIT B - Minin¢ 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 correlated with the map and should shoe where extraction will begin, and which direction, if any, it will proceed. EXH LB IT C - `fap This map should clearly define permit boundaries and indicate all roads or stockpile areas to be used in connection with the operation. .111 imeaediately adjacent landowers must be shown. The quarter section corner, section line, or any ocher locateable points should also be show on this map. EX^nIBIS D - Wildlife. Water Resources. Vegetation and Soils Information Each of the above-mentioned subjects must be addressed as outlined in the applicable RULE. EZHIB IT E - Reclamation Plan As with the mining plan, this should be a general discussion of the methods, equipment, phases or stages of the reclamation process and those portions of land affected by each. If possiSle, the plan should be closely correlated with the map. If not, the narrative must be comprehensive enough tp draw as accurate verbal picture of the expected appear- ance of the area after completion of reclamation. 'c!CdIBIT F - ProoF of Local Governmene Approval This must be a Letter from the local government spec'_fying conformance with existing zoning regulations. (I[ is intended that operators may obtain local government approval concurrent with the Division's processing of the apolication. To do so, the operator must submit evidence which indicates that local government approval is currently pending or will at least be considered within a reasonably short time by the appropriate govern- ing body RULE 1.1(10) (Consult this RULE for full details on this requirement.) E!CHIBIT G - Source of Legal Right to Enter This could be a cony of the lease, deed, abstract of title, or current tax receipt. An acceptable alternative would be a statement acknowledged by a notary public that the operator has the legal right to enter and mine. EYFiIBIT H - Reclamation Costs For a 110 permit, if the operator requests surety co be less than $2500, the ooeratormust submit facts to support such a request. Otherwise, a surety of $2500 will automatically be set. For all 111 permits, the surety shall be $2500 per acre. E.CHIBTT I - Terms of Governmental Contracts 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 [he surety provided under Che governmental contract, if it vas required. NOTICE PROCEDURES After the application is considered "filed" (pursuant to RULE 1.1(10) with the Mined Land Reclamation Division, notice procedures outlined in RULES 3.2 and/or r.2 must be followed. (Format for such notices will be included in the letter you receive from the 2fLR staff informing you of the completeness ("f Sling") of your application. ADDITIONAL INFOR<fATION This space can be referenced for further information of any of the items on [his form. To the best of my knowledge, all the information presented in this application is true and correct. / BY ~ J , TIr_:. ~,~, President (Si s't.=a inJ :':•: ~u..l !•~, it l•: auChor_ i..d to 'Sti~j C::e ep?rotor [o [his -- •' ice.. _ _,.... )