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-4- <br />12. Primary future (Post mialne) lend use (check oael: <br />Cropiand(CR) _ Pasturelaad(PL) <br />Raagelaad(RL) _ Forestry(FR) <br />_ Residrntial(1tS) ,_ Recreation(RC) <br />_ Developed WaterResources(1VR) <br />13. Primary uresent land uae {cheek o <br />Cropland(CR) _ Pastureland(PL) <br />Rangeland(RL) _ Fotestcy(FR) <br />_ Residential(RS) _ Recreation(RC) <br />_ Developed WaterResources(WR) <br />_ General Agriculture(GA) <br />_ Wildlife Habitat(WL) <br />_ IndustriaVCommercisl(IC) <br />_ Solid Waste Disposal(WD) <br />General Agricullure(GA) <br />_ Wildlife Habitat(WL) <br />_ IndustriallCommercial(IC) <br />Mining (MI`D <br />14. If this operation will use designated chenricals, or will result, or presently has acid mine drainage - you gannot use this application <br />form. Yoa must submit either a 1104 or 112d application form for Designated Mining Operahoat. In either case, you nmst list <br />any acidic or toxic-forming materials, exposed or disturbed as a result of the mjr~ing operation, a~ whether the Qperatioa will <br />15. Descriptor of Amendment or Conversion: <br />arc amending or converting an existing operation, provide a brief narrative describing the proposed change(s): <br />Mans & Exhibits: <br />Submit two (2) complete, unbound copies of the following application exhibits: <br />6.3. i EXHII3TT A -Legal Description and Location Map <br />6.3.2 EXHIIiTT B -Site Description <br />6.3.3 EXHIIiIT C -Mining Plan <br />6.3.4 EXHIBIT D -Reclamation Flan <br />6.3.5 EXHIIiIT E -Maps, to include the location of any recorded easements <br />6.3.6 EXHIBIT F -List of Other Permits and Licenses Required <br />6.3.7 EXHIBIT G - Source of Legal Right-to-Enter <br />6.3.8 EXHIBIT H - Municipaiities Within a Two-mile Radius <br />6.3.9 EXHIBTI' I - Proofof Filing with County Clerk <br />6.3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application <br />6.3.12 EXHIBIT L - Permanent Man-Made Structures <br />1.6.2(i)(b) ADDENDUM 1 -Notice Requirements (sample enclosed) <br />6.5 Geotechnical Stability Exhibit (as required) <br />