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.- <br /> , -z- <br /> TYPE OR PRINT CLEARLY <br /> 14. Present land use <br /> Agricultural <br /> • - (i.e. , agricultural, industrial, etc. ) <br /> 15. Proposed future land use Primarily Open Space for Re rea ion and <br /> (Coal of reclamation) Wildlife Use <br /> INSTRUCTIONS: This application form must be submitted in duplicate and each form must <br /> be accompanied by the following information and items. The application <br /> will not be processed until complete. See RULE 3 (for Limited Impact) <br /> or RULE 4 (for Special 10-day) for additional guidance. <br /> EXHIBIT A - Legal Description <br /> The legal description must identify the affected land and be wholly adequate for <br /> field location of the property. It can be in the form of metes and bounds survey <br /> or a description by reference to township, range, and section to at least the <br /> nearest quarter quarter section. Where applicable, the street address or lot <br /> number (s) may be used. <br /> I:XIIBIT B - Mining Plan <br /> This can be a general discussion of the methods, equipment, phases or stages of <br /> the operation and those portions of land affected by each. The plan should be <br /> closely correlated with the map and should show where extraction will begin, which <br /> direction it will proceed. <br /> • EXHIBIT C - Man <br /> This :nap should be as comprehensive as possible in terns of clearly defining <br /> the permit boundaries and indicating all roads or stockpile areas to be used in <br /> connection with the operation. :111 immediately adjacent landowners bust be sham. <br /> The closest quarter ;section corner, section line, or any other locateable point <br /> should also be shown on the map. <br /> EXHIBIT D - Wildlife , Water Resources , Vegetation and Soils Information <br /> Each of the above-mentioned subjects must be addressed as outlined in the <br /> applicable Rule, under item number ten (10) . <br /> EXHIBIT E - Reclamation Plan <br /> As with the mining plan, this should be a general discussion of the methods, <br /> equipment , phases or stages of the reclamation process and those portions of <br /> land affected by each. If possible, the plan should be closely correlated <br /> with the map. If not , the narrative must be comprehensive enough to draw an <br /> accurate verbal picture of the expected Physical appearance of the area after <br /> completion of reclamation. <br /> EXHIBIT F - Proof of Local Government Approval <br /> This must be a letter from the local government specifying conformance with <br /> • existing zoning revulations. <br /> EXEIB1T G - Source of Legal Right to Enter <br /> This could be a copy of the lease, deed, abstract of title, or current tax <br /> receipt. In lieu thereof, a statement acknowledged by a notary public that <br /> the operator has the legal right to enter and mine will be accepted. <br /> *rOR SPECIAL 10-DAY PERMITS ONLY** <br /> --MIBIT 11 - Reclamation Costs <br /> If the surety is requested to be less than $2500, the operator must submit <br /> facts to support such request . Otherwise a surety of $2500 will automatically <br /> be set . <br /> EXHIBIT I - Terns of Governmental Contract <br /> The operator must submit a copy of the contract or other proof that proves the <br /> necessity of a special 10-day permit. The operator must also submit evidence <br /> of the surety provided under the governmental contract , if it was required. <br /> A3 <br />