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<br />4- <br />!2. prbno_ra Allure (Posbmtolnal land use (chxkone): <br />_ Ctnplend(CR) <br />)(~ Rangelaad(I2L) <br />_ Residential(R3) <br />_- Developed Water Resoruces(WR) <br />13. Primary nroeont laud use (check one); <br />- Cropland(CR) <br />1L R~B~~(RL) <br />_ Reaidential(RS) <br />_ Developed Water Resawrcea (WR) <br />_ Pestureland(PL) _ OeceraLAgriculture(QA) <br />_ Forestry(FR) _ WikllifeHabitat(WL) <br />,_ Reereatiam(RC) _ IadustrlaVCommercial(IC) <br />T Solid Watte Disposal(WD) <br />Pastureland(PL) _ Clena'el A.griouitare(C3A) <br />_ Farostry(FR) ,.,,,_„ WildlifeHabitat(WL) <br />_ Recreazion(RC) _, IndustriaUComnaxcial(IC) <br />_, Mining (~) <br />14. If this operation will use dosigoated chemicals, or will result, or presently here sad mite: drainage -you ggpg~ use this application <br />form. Xou must submit either a 110dor 112d application foma forDesign~tedMining Opagtions. lneither~~~~, yon moat list any <br />acidic a~rtwtio-forming mata9als, exposed err diahubed as a result of the mining operation.and whethorthe operation will result is or <br />preear8y has acid mice drainage: <br />15. >;kecrtotlon oPAmea~~gt or avarsloe: <br />If you are aaunding a converting an existing operation, provide s brief narrative dasar'bing the proposed change(s): <br />Submit two (2) complete, unbotmd copies of the following application exhibits: <br />63.1 EJ(HIBIT A -Legal Description and Location Map <br />6.3.2 EXFIIBIT B -Site Description <br />6.3.3 EXHIBIT C -Mining Plan <br />6.3.4 EXfIIBIT D -Reclamation Plan <br />6.3.5 EXHIBIT E -Maps, to i~lude the location of atry recorded easeoxnts <br />6.3.6 EXHIBIT F -List of Other Permits and Licenses Roqutred <br />• - ounce o - <br />6.3.8 EXHIBIT H - MunicipaGdes Within aTwo-mile Radius <br />6.3.9 EXHIBIT I - Proof of Filing with Cormty Clerk <br />6.3.10 EXHIBT!' J - Proof of Mailing Notices of Permit Application <br />6,3.12 EXHBIT L -Permanent Man-Made Structures <br />1.6.2(I)(b) ADDENDUM 1-Native Requirements (sample enclosed) <br />6.5 Geoteclmical Stability Exhibit (as required) <br />