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~h TYPE OR PRINT CLEARLY 14. Present land use ~~ ~ A ~ _ ~ e ~ (i.e., agricultural, industrial, etc.) -z- 15. Proposed future land use ~,,,..t_.-E~_.:~, ~;,(1n ~ Ln,/- ~,;,, (Goal of reclamation) INSTRUCTIONS: This application form must be submitted in duplicate $nd each form must be accompanied by the following information and itemsl. The application will not be processed until complete. See RULE 3 (fo~ Limited Impact) or RULE 4 (for Special 10-day) for additional guidance. EXHIBIT 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 the form of metesland bounds survey or a description by reference to township, range, and section tQ at least the nearest quarter quarter section. Where applicable, the street address or lot number(s) may be used. EXHIBIT B - :fining Plan This can be a general discussion of the methods, equipment, pha es or stages of the operation and those portions of land affected by each. The plan should be closely correlated with the map and should show where extractio will begin, which direction it will proceed. EXHIBIT C - Mav This map should be as comprehensive the permit boundaries and indicatin connection with the operation. All The closest quarter section corner, should also be shown on the map. as possible in terms of clelrly defining all roads or stockpile are s to be used in immediately adjacent lando ers must be shown. section line, or any other docateable point I EXHIBIT D - Wildlife Water Resources, Ve etation and Soils Information Each of the above-mentioned subjects must be addressed as outli ed in the applicable Rule, under item number ten (10). EXHIBIT 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 thos portions of land affected by each. If possible, the plan should be closely correlated with the map. If not, the narrative must be comprehensive enou h to draw an accurate verbal picture of the expected physical appearance of the area after completion of reclamation. EXHIBIT F - Proof of Local Government Approval This must be a letter from the local government specifying conf~irmance with existing zoning regulations. EXHIBIT G - Source of Legal Right to Enter ~ This could be a copy of the lease, deed, abstract of title, or current tax receipt. In lieu thereof, a statement acknowledged by a notar public that the operator has the legal right to enter and mine will be acc pted. **FOR SPECIAL 10-DAY PERMITS ONLY** EXHIBIT H - Reclamation Costs If the surety is requested to be less than $2500, the operator must submit facts to support such request. Otherwise a surety of $2500 wild automatically be set. EXHIBIT I - Terms of Governmental Contract i The operator must submit a copy o£ the contract or other proof that proves the necessity of a special 10-day permit. The operator must also ubmit evidence of the surety provided under the governmental contract, if it as required.