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PERMFILE65254
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PERMFILE65254
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Entry Properties
Last modified
8/24/2016 11:11:05 PM
Creation date
11/20/2007 8:46:56 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1978143
IBM Index Class Name
Permit File
Doc Date
4/27/1978
Doc Name
LIMITED IMPACT AND SPECIAL PERMIT APPLICATION FORM
Media Type
D
Archive
No
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__ rE olt rllrrr_ cLr~ua.Y ~ <br />Presunr. land.O°1° Sanrl and gravel open pit <br />(1. e., agricultut'a.l, industrial, etc.) <br />5. 1'ro used future land use <br />p -W$9~e-E}i-6p66c1t Fri%_~r 7(xc•mml ink <br />Coal of recl.aation) 1'im0er Lo. <br />HSTRUCTIO:7S: This application form must be submitted in duplicate and each fora must <br />be accompanied by the following; information attd item:,. The application <br />Hill not' he processed until compl.e[e. See RULE 3 (for Limited Ic.pact') <br />or RULE k (for Special 10-day) for additional Ettidance. <br />::{IiIEIT A - Leaal Descrinti.on <br />The legal description must identify the affected land and be wholly adequate for <br />field location of the property. It can b~ in the form of metes and bounds survey <br />or a description by reference to township, range, atlcl section to at least Clte <br />nearest quarter quarter section. IRrere zlrplicable, the street address or to l• <br />number(s) may be used. <br />EXHIBIT B - ifi.nine Flan <br />This can be a general discussion of the methods, equipment, phases or stages of <br />the operation end those porticos of laud affected by each. The plan should be <br />closely correlated with the man and should show where extraction will begin, which <br />direction it will proceed. <br />C - <br />This map should be as comprehensive as possible i:t terns of clearly defining <br />the permit boundaries and indicati:;g all roads or stoc!:pile areas to b~: used i7 <br />connection %ti.tl: the oneration. ?11 irsnediate.Ly adjacent lattdownc:s must be sho~m. <br />The closest quarter section corner, section li:te, or at,y other locateabl.c point <br />should also be shown on the cap. <br />iAT1IBIT D -'dildlif.e, !dater Resources, Veeetatinn and Soils Infot=ti on <br />Eaclt of the above-r.,en[ioned subjects must be addrAssed as outl~.ned in t'te <br />applicable Rule, under item nual,er ten (].0). <br />IT E - Rec].acatior. Flan <br />As ~ritlt Che minin ; plan, tit <br />equipmenC, phz~es ur stages <br />land affected by each. If <br />Witlt the men. If nog, the <br />accurate verbal picture of <br />completion of reciat=al'ion. <br />IBIT r - Proof of T.ocal <br />I <br />•i'itis must' be a letter from the local government specifying coaforn&ttce with <br />existing zoning regulations. <br />~EXIiIBIT G - S <br />is s}tould be a general cl.isr.ussion of the met'.,cds, <br />of the recla~:~Cior. process and those. porticos of <br />possible, t!te plan sltnul.d be closc].y correlated <br />narrative must be co:prener.sive enough to draw an <br />t:te e:cpected physical appearance of the aria after <br />to Enter. <br />Tlris could be a copy of the lease, deed, al,strac~ of title, or current ta:: <br />Ieccipt. In lieu [hr.raof, a statement ac!:r.o~led!;ed by a notary public that <br />the oper::tor ltas talc legal ri&itt to enter and o,ine will be accepted. <br />~ **FOIl SFECI.IL 10-D;rY FE ~`tITS 0`TLY `* <br />IF.S}IIBIT 11 - T:cclam.-ttion Costs <br />If the surety is requested [o be less than $2500, the onr_rator must sub,ait <br />facts to support such request. Other.~isc a surety of ;2500 will automatically <br />be set. <br />C I - Tet-~,s of Covcrnmuntal Contract <br /> <br />The oprrnCur must submit n copy of the eoutracC or othr_r proof that pruven the <br />nucesni.Cy ol: :t ::pnCLa.L 10-d.:y pcr:nl.t. 'I'br•. npcrntur mnut al::o ::ubm.LC. cvld,~ucc~. <br />of the uurcty prnvid,ed under Clio guvununev~t:,J. euuCr;u1C, if. iC was rc<luircd. <br />
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