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4- <br />12, Primary future (Post-minine) Land use (check one): <br />Cropiand(CR) - Pasturctand(PL) <br />_ Rangeland(RL) _ Forestry(FR) <br />_ Residential{RS) _ Recreation(RC) <br />Developed Water Resoumes(WR) <br />13. Primary present land use (check one): <br />_ Cropland(CR) _ Pastmeland(PL) <br />Rangeland(RL) _ Fotestry(FR) <br />_ Residential(RS) _ Recrea[ion(RC) <br />Developed Water Resources (WR) <br />General Agriculture(GA) <br />Wildlife Habirat(WL) <br />Industrial/Commercial(IC) <br />Solid Waste Disposal(WD) <br />General Agriculture(GA) <br />t% Wildlife Babitat(WL) <br />IndustriallCommercial(IC) <br />Mining (MN) <br />14. If this operation will use designated chemicals, or will result, or presently has acid minedrainage - you c of use this application <br />form You must submit either a 1 lOd or ll 2d application form for Designated Mining Operafions. In either case, you must list <br />any acidic ortoxic-forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will <br />result in or prresently has acid mine drainage: <br />~/ <br />1 S. Descrintion of Amendment or Conversion: <br />If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): <br />,~/ /A <br />Maps & Exhibits: <br />Submit two (2) complete, unbound copies of the following application exhibits: <br />6.3.1 EXHIBIT A -Legal Description and Location Map <br />6.3.2 EXHIBIT B -Site Description <br />6.3.3 EXHIBIT C -Mining Plan <br />G.3.4 EXHIDIT D -Reclamation Plan <br />G.3.5 EXHIBIT E -Maps, to include the location of any recorded easements <br />6.3.6 EXHIBIT F -1_ist of Other Permits and Licenses Required <br />6.3.7 EXHIBIT G -Source of Legal Right-to-Enter <br />6.3.8 EXH78IT H -Municipalities Within aTwo-ttdle Radius <br />6.3.9 F,XHIDI'f I - Proof of Filing with County Clerk <br />6.3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application <br />6.3.12 EXHIBIT L -Permanent Man-Made Structures <br />1.6.2(1)(b) ADDENDUM 1 -Notice Requirements (sample enclosed) <br />6.5 Geotechnical Stability Exhibit (as required) <br />