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,~ -. <br />-2- <br />TYPE OR PRINT CLEARLY <br />14. Prevent land use <br />(S.e., agrlculcural, industrSal, etc.) Mi_RiIIg - L1 t8ni tm-Vanadillm <br />15. Proposed future land use Wildlife_habi_tat and dry rangeland <br />(Wet o[ roc lamatlon) <br />INSTRUCTIONS: This app Lit a[Son form must be eubml[ted 1n duplicate end each form muse <br />be accompe^led by the follow Sng Snformac SUn and Stems. The application <br />will not be pro [eeaed until comp to ce. Sre RULE 1 (for Ltm iced Impncc) <br />or 0.lJLE 4 ((or Special t0-day) (nr adrift tonal gu lda nee. <br />EXHIBIT A - Legal De scriptlon <br />The legal des cr tpclon aunt iden[!fy [he affected land and be wholly edequa [e for <br />f Seld loca[Son of [lie pro pe r[y. It can be In the form of mecca and bounds survey <br />or a deoc ripcfon by reference [a townahtp, range, end section [o a[ le sec chc <br />nearest quor ter quarter section. 'there eppllc ab le, the street address or lot <br />number(s) may be used. <br />EXH IB LT B - Mining Plan <br />This can be a general dls case ion of [he methods, equ Lpmen[, phe see or sea gas of <br />[he operation and those por[lone of land effected by ea cli. The plan ahou ld be <br />closely corrc laced vich the map and should show where extraction will be gin, vh lch <br />dlrec[SOn It will proceed. <br />EXHIBIT C - Map <br />This map ^hould be as comprehensive as posy Lb le Sn ter me of clearly def In ing <br />[he pe rml[ boundaries and lnd Sta[Sng all roods or sco cl<p 11e areas co be used in <br />connec[lon vl[h C:~c operation. All in®ed is ce ly ad]at eu[ landowners must 6e shown. <br />The closes[ quarter sec[Son corner, sect ton line, or any ocher lot a[eable point <br />should also he sheen an the map. <br />EXHIBIT D - 411d11fe Va ter Resources, Vegecot ton and Soils Info rma[lon <br />Each of [he above-mentioned aub]et is muec he addree srd as ou[llned in [he <br />epplScable Rule, under item numbrr [en (10). <br />EXHIBIT E - Reclamaclon Plan <br />Ae vich [he min Sng plan, this should be a general dlscueslon of the me [hod s, <br />equlpmen[, phases or scagea of the reel eme[Son process and [hose pore Sons of <br />land aEtec Ced by each. If poealble, [he plan should be closely tome La fed <br />v lth the map. if no [, [he narra[Sve oust be comprehensive enough to draw an <br />accurate verbal plc cure of [he expected physical ap penrance of [he area of ter <br />comple[lon of retlama elon. <br />EXHIBIT F - Proof o[ Local Government Ap pro vat <br />This must be a Sec ter from [he lot sl gove come nc epeeSCy log conf orme nee with <br />axle clog ton log re gulatlone. <br />EXHIBIT G - Source of Legnl RSghc [o Enrer <br />This Could be a copy of the lease, deed, aba[r etc of title, or current tax <br />receipt. In lieu thereof, a statement ac know lodged by a no ca ry public chat <br />[ha operator has the legal rlgh[ [o enter end mine will be accep tad. <br />•"FOR SPECIAL 10-DAY PERMITS ONLY •• <br />Ea11BIT H - Rec lamatlon Coe [s <br />I( the surety is requee[ed to be lees then 52500, the operator muse submit <br />fee is [o support such reque ec. Ocherv Sse a surety of 52500 will au[oaacice Sly <br />be se [. <br />EXHIBIT I - Terms of Covernmc n[al Cont cart <br />The operator mug[ aubmlt a copy of the contract or other proof chat proves the <br />neceeeity of a epee Sal 10-day pe rnic. The operator must also subml[ ev Ldence <br />of [he surety prow Lded under the governmen cal contras c, Sf f[ was re qu Lred. <br />