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_ ~ TYPE OR PRINT CLE.~IRI,Y 14. Present Iaad use Pasture land. (i.e., agricultural, industrial, etc.) 15. Proposed-future land use Pasture-land.- (Goal of reclamation) • - - _...~... INSTRUCTIONS: This application fo:-m must be submitted in duplicate and each form must 6e accompanied by the following information and items. The application will not be processed until complete. See RULE 3 (for Limited Impact) or RULE 4 (for Special 10-dap) for additional guidance. EXSLBIT A - Legal Description I The legal description must identify the affected land and be whollq adequate for field location of the property. It can be in the form of mites and bounds survey or a description by reference to township, range, and section to at least the nearest quarter quarter section. Where applicable, the street address or lot number(s) may be used. EXHIBIT 3 - ifining Plan This can be a general discussion of the methods, equipment, phases or stages of the operation and those portions of Iaad affected by each. The plan should be closely correlated with the map and should shoe where extraction will begin, which direction it will proceed. E.~IBIT C - MaP This map should be as comprehensive as possible is *_erms of clearly defining the permit boundaries and indicating all roads or stockpile areas to be uged is connection with the operation. A.II immediately adjacent landowners must be shown. The closest quarter section corner, section line, or any other locateable point should also be shown on the map. EY3I3IT D - Wildlife, Water Resourtes, Vegetation and Soils Information Each of the above-mentioned subjects must be addressed as outlined is the applicable Rale, under item number ten (10). EXHIBIT E - Reclamation Plan As with the mining plan, this should be a general discussion of the methods, equipment, phases or stages of the reclamation process and those portions of land affected by each. If possible, the plan should be closely correlated with the map. If not, the narrative must be comprehensive enough to draw an accurate verbal picture of the expected physical appearance of the area after completion of reclamation. EXHIBIT F - Proof of Local Government Approval This must be a letter from the local government specifying conformance with existing zoning regulations. ERFiIBIT G - Source of Legal Right to Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. In lieu thereof, a statement acknowledged by a notary public that the operator has the legal right to enter and mine will be accepted. **FOR SPECIAL 10-DAY PER`SITS ONLY** E;tHIBIT $ - Reclamation Costs If the surety is requested to be less than $2500, the operator must submit facts to support such request. Othezwise a surety of $2500 will automatically be set. E.CFiIBIT I - Terms of Governmental Contract The operator must submit a copq of the contract or ocher proof that proves the necessity of a special 10-day permit. The operator must also submit evidence of the surety provided under the governmental contract, if it was required.