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PERMFILE56859
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PERMFILE56859
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Entry Properties
Last modified
8/24/2016 10:59:19 PM
Creation date
11/20/2007 5:12:54 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1979163
IBM Index Class Name
Permit File
Doc Date
9/4/1979
Doc Name
LIMITED IMPACT 110 & SPECIAL 10 DAY 111 PERMIT APPLICATION FORM
Media Type
D
Archive
No
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;h, Presant land usa (i .e., ayri- ~- ~ Grassland <br />cnl[u ral, industrial, c[c.) --- <br />15. Prcposcd future land use Grassland <br />(Goal of reel zmation) <br />1[15TRUC71 Ott5: This applica[i on and all acc onpanying materials must be submitud in duplica [e. <br />In [he into rests of u(ficient prx essinn, please include the following informa- <br />tion L items. limited Iepac[ DDe rations, ste RULE 3 for guidznce; Special 10- <br />da~~ Permits, see RULE 4 for guidance. <br />ESH181T A - Le gal Oescri o[ion .~ <br />The legal de scripcion must identify the affec [ed land and be •~holly adequate for <br />field location of the property. It can be in the form of metes L bounds survey <br />or a description Ey reference [o tcwnsh ip, rang?, and section, to a[ leas[ [he <br />nca re st quarter-gtar[er section. 'dhe re applicable, [he street add rt zs or lot <br />number(s) may be cse d. <br />EXHIBIT B - Hininc Plan <br />This can be z gene ral discussion of [he mP[hods, equipment, phases or stages of the <br />operation and tho=e portions of land affected by each. The plan shculd be <br />correlated with [t.e nap and should sh cw (.here extrac[ien wi 11 begin, and which <br />dl rection, if any. it will proceed. <br />EXHIBIT C - Hab <br />This map should clearly define permit hcun dories and indicate all roads or s;ocL:pi le <br />areas to be used in cenn eciion with [he operation. All irricdiate ly adjacent landowners <br />must be shown. Tire quarter section corner, section line, or~any ether Iota [cable points <br />should also be shown cn [his nap. <br />E%HIBIT D - 'ai ldlife, eater Resources, l'e ye tati on and Soils Infer coati on <br />Each of the above-mentioned subjects must be addressed as outlined in [he applicable <br />fiUL E. <br />EXHIBIT E - ..°.eclama[icn Plan <br />As with [he Wining plan, this should be a general discussicn of [he methods, equipren[, <br />phases or stages .of the reclamation process and those po rcions of land of fee t.:d by each. - <br />if pass isle, [he plan shculd be closely correlated with [he map, If not, the narrative <br />must be ronpr?pensive enough to draw an acc era [e verbal pict ur •_ of the expected appear- <br />ance of the area after completion of rte lanation. <br />FXH1817 F - 7reo( Of Local G•;vernmen[ Agp rc val ._ <br />i.his must be a Ie t;er From [he local geve rn ment specifying ccnfo r. .a nee with existing <br />zoning regula[icns, (I[ is intended that ape rotors mey obtain local gave rnsrnt approval <br />concurrent with Ibe Division's prec?sling of [he applica a cn. To do so, the operator <br />must sutnit evidence •.:hi <h indicates that local govt. approval is currently tending <br />or will a[ leas[ Se co r.s idc red vi [h in a reascnably short tine by :he appropriate <br />gave ruing body, .RULE I.I (10) (Consul[ this RU LE roc full de [ails on [his r?qui rc men[.) <br />EXH181T G - Sourr.e of Le cal Rich[ [o Enter <br />This could be a ~:opy of [tie lease, deed, abstract of title, or current tax rote ip [. <br />An accep[zhle alto rna N ve would ba a sta[emunt ackn ewledged by a notary pu tli< :hz[ <br />the operator has the loyal right to enter and nine. <br />E%H IO IT H - Recl xmatiui Ccs is <br />If the sure [y is r2 Guested to be less thin $ZSGU, the operator rust submit facts to <br />support sucb a recur. sc. Othe rise, a sure Cy of 52500 will automatically be set. <br />~•..d FOR SPECIAL 1O-DAY (111) PEf41175 ONLY ~~-- <br />EXHI6 IT I - Te res cf Geve rg r.?ntal Ccnt ract <br />For Special 10-Coy (111) Permits, the ape rotor must submit a copy of the contract or <br />othr.r proof that ,:cues the ne cessi[y of a speci a! 10-lay ('er~i [. The cperator r..us[ <br />also submit evidence of the surety provi d?d and?r the ycvernne n[al contract, if i[ was <br />required. ' <br />DOTICE PFCC EGU P.Eg <br />A (ter :he appli•:a[i on is censi de red "filed" (pursuant [o SULE 1.1(10) sri th the Y,i Wed Land <br />e+_c lana[ien Division, cotice prccedures outlined in RULES 3.2 v/or 4.2 must to (cllc'•:e d. <br />(FCrna; fur secs r.ot ices will be ir.clud?d in :he let er you receive from the •7LR s[a ff <br />inforeing ycu of ;he epr„pl etc n,_ss ("filing") of your appl ica[i on. <br />AGOIT IQY.AL IkFC BRATI CN <br />This space can .e referenced for further info rmation of eny of [he item; en [his (o rm. <br /> <br />To the best of my kncwlcdge, all the in fo rr,.a[ion presto ted i this apClica [i on is rue <br />and correct. <br />BY / <br />iIiLE '~ ' ~~~~ <br />.g eJ ey inu ii Cti~ Icg.ally author- <br />i_cJ [o bi r.d the up~: ra[or'[o this <br />a pplica[inn.) <br /> <br />u <br /> <br />
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