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110 Permit .Aoolicatiop (cont'd�
<br /> 'INSTRUCTIONS: This application and all acromppny'ng materials must be submitted in
<br /> duplicate. In the interests of efficient prr,eising. ,-..case include
<br /> the folluviig infora`_s __c I.1=__td _ cc- ^;^:atiaac _ FLULE
<br /> 3 for guidance; Special l0-day permits, see RULE 4 for guidance.--
<br /> EXHIBIT A - Legal Description
<br /> The Legal description must identify the affected land and be wholly adequate for field
<br /> location of the property. It can be in the fcrm 2f metes 3 bounds survey or a descrip-
<br /> tion by reference to township, range, and section, to at least the nearest quarter-
<br /> quarter section. Where applicable, the street adiress or lot number(s) my be used.
<br /> EXHIBIT B - Pining Plan
<br /> This can be a general discussion of the methods, equipment, phases or stages of the
<br /> operation aad those portions of land affected by each. The plan should be correlated
<br /> with the map and should show where extraction wil begin, and which direction, if any,
<br /> it will proceed.
<br /> EXHIBIT C - Mao
<br /> This map should clearly define permit boundaries 3nd indicate all roads or stockpile
<br /> areas to be used in connection with the operation. A.11 immediately adjacent landowners
<br /> must be shown. The quarter section corner, section line, or any other locateable
<br /> points should also be shown on this map.
<br /> ERHL9I7 D - Wildlife, Water Resources, Vegetation and Soils Information
<br /> Each of the above-mentioned subjects must be add seed as outlined in the applicable
<br /> RISE.
<br /> EXHIBIT E - Reclamation Plan
<br /> As with the mining plan, this should be a general discussion of the methods, equipment,
<br /> phases or stages of the reclamation process and c ose portions of land affected by each.
<br /> If possible, the plan should be closely correlate with the map. If not, the narrative
<br /> must be comprehensive enough to draw an accurate verbal picture of the expected appear-
<br /> ance of the area after completion of reclamation.
<br /> E=- I- F - Proof of Local Goverment Approval
<br /> This must be a letter from the local government s ecifying conformance with existing
<br /> zoning regulations. (It is intended that operators may obcaia local government approval
<br /> concurrent with the Division's processing of the application., To do so, the operator
<br /> must submit evidence which indicates that local government approval is currently pending
<br /> ar :rill at leaat be considered uithia a reasouabl7 short timc by the appropriate gcve:l-
<br /> Lag body . . . RULE 1.1(10) (Consult this RLLE. for full details on this requirement.)
<br /> EXHIBIT G - Source of Legal Right to Enter
<br /> This could be a copy of the' lease, deed, abstract of title, or current tax receipt.
<br /> An acceptable alternative would be a statement acknowledged by a notary public that
<br /> the operator has the legal right to enter and mine.
<br /> EXRIBIT H - Reclamation Costs
<br /> For a 110 permit, if the operator requests surety to be less than $2500, the overatormust
<br /> submit facts to support such a repuesc. Other ris , a surety of $2500 will automatically
<br /> b____e,,,,,,,,,,,,,,,,,,��-�s�1�11e. For all 111 permits, the surety shall be $2500 per acre.
<br /> T I - Terms of Governmental Contracts F Special 10-Day (111) Permits, the operatort subl�/1 A,copy of the contract or
<br /> other proof that proves the necessity of a spec 10day permit. The operator must
<br /> also submit evidence of the surety provided under the governmental contract, if it was
<br /> required.
<br /> NOTICE PROCED S
<br /> :After the application is considere¢ "filed" (purr LaMt co RULE! 1.1(10) with the Mined
<br /> Land Reclamation Division, notice procedures outl ned in RULES 3.2 and/or 4.2 must be
<br /> followed. (Format for such notices will be inclu ed in the letter you receive from the
<br /> ,a2 staff informing you of the completeness ("fil g") of your application.
<br /> ADDITIONAL ?PIFOR.w.A ION
<br /> This space can be referenced for further inform on of any of the items on this form.
<br /> i
<br /> To the best of my knowledge, all the information resented in this application is true
<br /> and correct.
<br /> BY
<br /> TITL-
<br /> ( iZtAcd :�: _.. _ . Aau_1 ! •-;1�.. .:nC�a r-
<br /> ta� e,erator to :!:is
<br />
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