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14. Present land +~se (I .e., agri- ~/~ O ~/.';/i / (/,~'~?/ - ~
<br />cultural, indt~st ria 1, etc.) -~'
<br />15, Proposed futu~e land use ?n F ~ /7/i(//(/~ ,' NA; ~ ~~
<br />(Gael of recl motion) /NFi~R/1~~ 17 ,F/ FA.S'n ~~~~//ti
<br />INSTRUCTIONS: Thi applica[IDn and all accompanying materials must be suhmitied in duplicate.
<br />In he Interests of +:fficient processing;~please Intl udn the following Informa-
<br />ci 6 Items. ~Lfmt t+:d Impact Operations, sea RULE 3 for guidance; Special 10-
<br />day Pe rmlts, see RULIE 4 for guldance.~
<br />'YHIa1T e - I.nal n~ar.I~nrlnn -.-. --.- ..--_
<br />The legal des[ ripci n must identify [he affected land and be wholly adequ:lte for
<br />field loeatlen of t e property. It can be in the form of metes c bqunds :lurvay
<br />or a description by reference to [awash ip, range, and section, to at least the
<br />nearest quarter-qua ter section. Vlhe re applicable, Che street address or lot
<br />number(s) may 6n us~d. .
<br />This can be a genet I discussion of the methods, equ lpmen [, phases or stages of Che
<br />operation and chase portions of land affected by each. The plan should ble
<br />correlated with the map and should show where extraction will begin, and which
<br />dl rectton, If any, ~I[ will proceed. -~
<br />EXHIBIT C - nap
<br />This map should cl e'rly define permit boundaries and Indicate all hoods or stockpile
<br />areas to be used in connection with the operation. All Irtmediately adJac enc landowners
<br />must he shown. The quarter section corner, section line, or~any other Inca teable points
<br />should also be show on this map.
<br />EXHIBIT D - Mlldlif~e 4ater Resources, Ve e[ati on and Soils Information
<br />Each of the shove-mentioned subjects must be addressed as outlined in [he applicable
<br />RULE.
<br />EXHIBIT E - Reclamation Plan
<br />As with the mining~ian, this shauid be a gene tai ui icuaai v., .., Y5e r,~,;;,,,;;, ~.,df pu,ult,
<br />EXHIB too o Lo a t p
<br />ThIS must 6e a letter from the local government specifying conformance with existing
<br />xGn ing ;=y^ula[i~-:. +'t I• I"•!^•+-a 'r•=' o;~'e'^~• ^'y okra in lnral gnvw rmm~nt aooroval
<br />concurrent with [he Division's processing of the application. To do so, the operator
<br />r.~.:;t s:..:it avl.=: :.~ ::". _` '-:I Cot.. •~:t lac=' ^^ •. spp ravel is currently pending
<br />or will-at least h considered within a tea sonably ,sho rt time by the appropriate
<br />gov. rninn body. .RULE 1.1(101 (Consul[ this RULE for full details on this requirement.)
<br />Fru Iq IT n - SDlirre of Iwnal Rl ah[ to Entwr
<br />This could be a copy of [he lease, deed, abstract of tl [le, or current tax receipt.
<br />M acceptable al[erna ti ve would 6e a statement acknowledged by a notary public chat
<br />the operator has tke legal ri aht to enter and mine.
<br />EXHIBIT H - Reclam [i an Costs
<br />If the surety is requested to be less than $2500, the operator must submit facts to ~~~
<br />support such a raq~asi. Otherwise, a surety of 52500 will automatically be set.
<br />*** FOR SPECIAL 10-DAY (III) PERHI TS ONLY ~**
<br />EXHIBIT I - Terms of Governme n[al Contract
<br />for Special 10-Day 1(111) Permits, [he operator must submit a caDY of [he contract or
<br />ocher-proof that proves the necessity of a special 10-day permit. The operator must
<br />also submit eviden a of the surety provided under the governmental contract, If it was
<br />required. ~ ~-
<br />NOTICE PROCEDURES
<br />After the applicat on is considered "filed" (Pursuant co RULE I.l(10) with the Mined land
<br />Reclamation Dlvisi n, notice procedures outlined in RULES 3.2 6/or 4.2 must be followed.
<br />(Format for such n¢ticns will 6e included in the letter you receive from the MLR staff
<br />Informing you of Che completeness ("filing") of your aDPl lca[i on.
<br />ADDITIONAL INFORMATION
<br />This space can be ciafe rented for further information of any of [he items on this form.
<br />TNF /1~1/I ~YJ F.' / T I/ n F T,~/F,+"' F" f ~ 1~1/// / /7/1// Y
<br />~~ / , ~ ~n +'~it/~i c i /1/ ~ 3 T~ .~ 1/F ,E~'-' %/ l FMS ~
<br />phases or stages o II the reclamation process and those portions of land affected by each.
<br />If pass lble, the plan should be closely correlated with the map. If not, the narrative
<br />must be comprehens i~+e enough to draw an accurate va rbat picture o` the expected appear-
<br />ance of the area after completion of reclamation.
<br />IT F- P f f c 1 Gove rumen A ravel
<br />To the best of my knowledge, all [ha information presented in [his applica tl on Is true
<br />and, correct. ,~J J
<br />v~,L~ ~ - !(.'Lf2t-CIS BY
<br />r
<br />y~~ ~ /f ~~, TITLE
<br />/// +rrcJ~ Si ed by ~ ivid ual egel author-
<br />/ ~ ~ i ed to bind the ~ ra mr o Lhis
<br />application.)
<br />
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