PERMFILE62429

• Permit No: M1978249
• IBM Index Class Name: Permit File
• Doc Date: 7/21/1978
• Doc Name: LIMITED IMPACT & SPECIAL 10 DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

TYPE OR PRINT CLEARLY
14. Present land use AgriCUlturdl
(i.e., agricultural, industrial, etc.)
15. Proposed future land use Recontour the land and return to native
(Goal of reclamation) vegetation
INSTRUCTIONS: This application form must be submitted in duplicate and each form must
be 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-day) for additional guidance.
E~IIBIT A - Legal Description
The legal description must identify the affected land and be wholly adequate for
field location of the property. It can be in the form of metes 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.
E:OiIBIT B - fining Plan
This can be a general discussion of the methods, equipment, phases or stages of
the operation and those portions of land affected by each. The plan should be
closely correlated with the map and should show where extraction will begin, which
direction it will proceed.
E'~TIBIT C - `fao
This map should be as comprehensive as possible in terns of clearly defining
the permit boundaries and indicating all roads or stockpile areas to be used in
connection •aith the operation. All 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.
E!OfIBIT D - r.+ildlife, Wa=er Resources, Vegetation and Soils Information
Each of the above-mentioned subjects must be addressed as outlined in the
applicable Rule, under item number ten (10).
E%Y.IBIT 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 aad 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.
E.`OiIBIT F - Proof of Local Government Approval
This must be a letter from the local government specifying conformance with
existing zoning regulations.
E.'3riIBIT 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 ac!caowledged by a notary public that
the operator has toe legal right to enter and mire will be accepted.
**FOR SFECIAL 10-DAY PERi•IITS OJILY**
E~jI3iT '1 - Rec'_amation Costs
If the surety is requested to be less than $2500, the operator must submit
facts to support such request. Other.+ise a surety of $2500 will automatically
be set.
ES7'.IBIT I - Terms of Governmental Contract
The operator must submit a copy of the contract or other proof that proves the
necessity of a special 10-day ?emit. The operator must also submit evidence
of the surety provided under the governmental contract, if it was required.