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14. Present land u# AGRICULTURAL \ __ .(i.e., agriculutural, industrial, etc.) ' 15. Proposed future laced use _ (Goal. of.reclamation) INSTRUCTIONS: this appllcation form must be submitted in duplicate and each form must be accompanied by the following information and items. The application will not be proeesaed until complete. See RULE 3 (for Limited Impact) or RULE 4 (for Special 10-day) for additional guidance. EXHIBIT A - Legal Description Thn legal description moat identify the affected land and be wholly adequate for field location of the property. It can be is the form of metes and bounds survey or a description by reference to township, range, and sectloa to at least the nearest quarter quarter section. Where applicable, the street address or lot number(s) may be used. EXHIBIT B - Mininit Plan This eaa be a general discussion of the methods, equipment, phases or stages of the operation sad those portions of land affected by each. The play should bn closely correlated with the map sad should show vhera extraction will begin, which direction it will proceed. EXEiIBIT C - Map This map should be as comprehensive as posaibla in terms of clearly defining the permit boundaries and indicating all roads or stockpile areas to be used in connection with the operation. All immediately adjacent landowners must ba shown. The closest quarter section corner, section line, or any other locateable point should also be shown on the map. EXHIBIT D - Wildlife, Water Resources, VegetaCion and Soils Information - Each of the above-mentioned subjects must be addressed as outlined is the applicable Rule, under item number ten (10). EXHIBIT E - Reclamation Plan - As with the mining plea, 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 eat, the narrative must ba comprehensive enough to draw as accurate verbal picture of the eapeeted appearance of the area after completion of reclamation. EXHIBIT F - Proof of Local Government Approval This must ba a letter from the local government specifying conformance with ezisting zoning regulations. EXHIBIT C - Saurca of Legal Ristht to Enter - This could ba a copy of the lease, deed, abstract of tit la, or current taz receipt. Ice lieu thereof, a statement acknowledged by a notary public that the operator has the legal right to eater sad mice will ba accepted. EXHIBIT B - Reclamation Costs If the surety is requested to be less than $2500, the operator must submit facts to support such request. Otherwise a surety of $2500 will automatically be sat. **EXHIBZT 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 permit. The operator must also submit evidence of the surety provided under the governmental contract, if it was required. ~-*FOR SPECIAL 10-DAY PERMITS ONLY