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14. Presun( land m•. (i .e., agri- Grassland cultural, industrial, etc.) 15. Proposrd future land use Grassland (Goal of reclamation) IIISTRUCTICNS: This application and all accompanying ma [erial5 must be submitted in duplicate. In the interests of u(f icient processing, pleasz include thr following informa- tion E items, limited Impact Operations, see RULE 3 for gui d.mce; Sptcial 10- day Perri ts, see PULE 4 for guidance. E%HIBIT A - Legal Descri otion The 1tga1 d?sc ripticn must identify (he afro clod land and be wholly adequate for fitld location of [he property. It can be in the form of metes E tcunds survey or a descri pion ty reference to [r.+nship, range, and section, to at least the nearest quarter-gtar[tr 5eciiOn. '.here applicable, the street add rt ss or !o[ number(s) ray be csed, E%HIBIT B - 15ininc Plan • This can be z ye cc rat discussion of [he methods, equipment, phases or stages of the operation znd those porticos of land of Fec led by each. The plan shcutd be Correlated vi [h [he map and should sh as wht re extraction will begin, and which dl rection, if any, it will proceed. EXHIBIT C - Map This map should c~ea rl•y define permit bcun daries and indicate all roads or stockpile areas to be used n connection with the operation. All inaedia[ely adj aeon[ landowners nos[ bz shown. ilre vuar[er section corner, section line, or any ether loca[eable points should also be shown cn [his map. E%HIBIT D - tli ldl ife, 'aa t~=r Resources, l'•_qe [an on and Soils Infor nati on Each of [he above ;mentioned subj tt [5 must be addressed as outlined in the applicable ' FUL E. EXHIBIT E - ..°.ecla nation Plan As with the .~i Wing plan, this should be a general discussion of the methods, equipment, phases or stages of [he reclamation process and those portions of land affected by each. If possible, the plan should be closaly correlated with the map., If not, the na native nos[ to coma re hensive anough [o draw an accu ra Ce verbal picture of the expected appear- +n ce of the area after completion of reclamation. %HIBIT F - PrcoF of Local Government ~^.o re vat This must be a letter frm [he local 5c•:e rn moot specifying conformance with txis[ing zoning regulations. (It is intended [hat ope ra [ors nay obtain local government apO royal , tenter rent with the Di vision's processing of the application. To do so, the operator must submit e•ri de net •.+h ich indicates [SaY local govt. app royal. is currently :ending • or 'dill at least Se co aside red wi (h in a tea senably sho r[ time by the appropriate cove ruing body. .RULE I.I (10) (Consul[ this RULE for full details en this raqui rc cent .) EXHIBIT G - Sxrce of le cal Rich[ to Enter This could be a rcFY or [he Ic ase, decd, abstract of title, or current fax receip [. An acceCtable al [e rna t: ve •woald 6a a statement acknc.+l edg?d by a notary public .hat the operator has the legal right to enttr and nine. E%41017 H - P.ecl.~maticn Cos CS If the surety is re ques[td to be less than $25C0, the oiler aior roust submit facts [o support such a rv:gces[, OL`•e r.:i se, a surety of SZj00 will automatically be set. ~~-' fOR SPECIAL 10-DAY (111) PC WHITS OI1LY EXHIBIT I - ,er m~: cf rover~ce~tal Contract For Sp?cial 10-D ly (I Il) Permits, the ope razor oust =. ubmi[ a copy of the contract or other proof that proven ;he nt cessi Cr of a special 10-day per~i[. The r.pt ra for must also submit evi!=net of the su rn[y provi d?d undo:r the ge vet no?ntal trot tact, iF it 'aas reG ui r?d. I:OTICE PSCC EOURES A f[er (f.? appli<a[i on is censi d?red "filed" (pursuant [o '.ULE 1.1(10) rri [h [hc 4incd Land R.~r lamaticn Division, cotice procedures outlined in RULES }.2 L/or 4.2 must b? fol k:+e d, (FC rna; for sue.` rot ices rei 11 6e included in ;he letter you receivt frc:n [ht NLR staff infor-i ng you cY ;he cc-~plc[e ~?ss ("f it log") of your aopl ica(i on. AUOITIJIlAL IgFC.°.YATI CH ibis space can :e re fe rcn<ed for further info r:nation of any of tht items en [his form. TO the best of ay <ncwlcdye, all [ht in (o rr:a[ien prtsen[ed in this aaplirati on is true and correct. BY TITLE tSigred Oy i'lU r•/r G'Udl I, golly ?UthJr- izcd to bind the op?ra [o r'to this a ppli~:a[ion.)