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110 Permit Apnlication (ten t'd
<br />IL. Present land use (i,e., agrl- wf'raZe Land
<br />cultural, indus[ri al, etc.) ---
<br />15. Proposed fu byre land u;c Return to_presPnt n^.P
<br />(Goal of reclamation) (-
<br />IIISTRUCil Ot15: This application and all accompanying materials Host be suoni[[ed in duplicate.
<br />In the interests of efficient processine, please include Lye folle.ring informa-
<br />tion & ire mss. Limited Inoact Gae ration;, sea MULE 3 For guidance; Special 10-
<br />day Pc rnits, see n"ULE ~ For Guidance.
<br />E %IIIBIT A - !coal Oescrlction
<br />The legal de s<ripticn nos[ idcnti fy [he aFieeted land and 6e >,holly adequate for
<br />field location of L''•a property. It can ae In tLc form or me[as v hounds 5urvev
<br />or a description Sy reference [o torn sh its, rar ee, and section, [o a[ ie ast the
<br />nets rest Gua rte r-e ua r[er section. uhe re appifca6le, the street .address or lot
<br />number(s) may to used.
<br />EXHIBIT B - ninico Plen
<br />This can be a cone ral dis_ussion of the methods, equipment, phases or stages of the
<br />operation ar,d ;PO>e por:ions of land af`ectec by each. The plan should SE
<br />Co rrel axed wi ch [he nap ar,i should shoo-, .,here ex[rac tl on will be?in, and ¢~hich
<br />direction, if any, it :,ill proceed.
<br />EX4IEli C - ,Mau
<br />This map should Ilea: ly define pu rmi[ boundaries and indicate all roads or stockpile
<br />areas to be used in tonne c+.i on with [he ope ra[ior. All immediately aejacent IanGaaner;
<br />must be shoran. Th_ yuar[er section corner, section line, or any other !ocatea6le points
<br />should also be sho'.,n on ch s map.
<br />EXHIBIT 0 - [li ldi ife, Wa:cr °esou rtes, 'Je ceta[ion and Scils Inf ernati on
<br />Each of :he above-nention e' subjects must be ad dressed as outlined in Cie applicable
<br />4L'L E.
<br />EXHIBIT E - 4ec1?coati on Plan
<br />As with the minino plan, this >hould be a general discussion cf the methods, eauiomen_,
<br />phases or s:anes of the reclamation orcces5 and ;hose pe rtions or land affec•ad by each.
<br />If poss ibl =., the plan s~o~-Id be cl osely cc rre laced with ;he may, If not, [F,e na rrativa
<br />must be comp reh =_ns ive eoctgh to draw an ac<u ra [e verbal picture of :he expected appea r
<br />ante of L.e area after coamletion of reclamation.
<br />EXHIBI' - - Proof eE Local Gcve -noon[ :~.op royal "f
<br />ibis nos[ be a letter frrnl [he local go ve rn men[ soecifyiog conformance with esistina
<br />zpniny re gulatiors. (I[ in tendeu [hat ope ra[or5 may rt'ain local governnent approval
<br />concurrent with [he Oisis en's oroc essinq of the application, Ta ~o so, the ope ra [or
<br />must submit evi?coca +ar ich indicts tes [hat local govt, approval is currently oe ndina
<br />cr s,i 11 at leas: be tors hie red .,i to in a reasonably short time by iha ap?rooriate
<br />co ve rn ine body. .PULE I.1 (10) (Consult :his P.U LE for full c=_[ails on this requi raven[.)
<br />E:?dIB1T u - So~_rr,t of Lensi Pi ant to E~te.-
<br />This could ba a copy of t•.e leas=, deed, abstract of title, or current tan re talc t.
<br />An acceptable altern=_-i ve would be a s[a[ement ach,n c~.~ledged by a notary public that
<br />the ope ra br has the local rich[ to enter and nine.
<br />E Y.H IBIT H - Recl=oration ':o; [s
<br />IF [he surety is reque s:_d [c he less than 52500, [he operator r..ust submit facts [o
<br />suopo rt such a re_uest. Othe reise, a su rev of 52500 will automa[ical l•/ he 5e t.
<br />"+~ FOR SPECIAL 10-OA/ (I I1) PERMITS 0>!LY ^~~-
<br />EXHIBIT I - 7e rms of Guve cocoon [al Con[rac[
<br />For Special 10-Day (111) Fermits, the operator must submit a cony of the con rract or
<br />other prcof that proves ':he necessi :v of a saeciat 10-day permit. The operator mu>[
<br />also sabmi[ evid?nee of :ne surety provided under the governme n;al contract, iF it .gas
<br />reG ui red.
<br />'I; TILE RPOC EDURES
<br />.'ter t`x applicau rn is cons lde red "flied" (pursuant [o .'.ULE 1.1(10) wi [h Ibe Mined land
<br />ocicma.. a Di'. •. sick n;a ice orocadu~r; r.,[lirfd in Alll :; j,2 P,iar 11„2 nVK: hr fpllUwed.
<br />iFO rots: for wc~ notices 'ai 11 he inclutled in the letter ycu receive frcn the nLR staff
<br />info rr.~ing yCU of :he aY[pla tenets ("fil in ~"} of yoat applica[i on.
<br />AOCITI CfIwL 1;lF^RMATI
<br />This spacb can be refer:ncod for further info rma[ion of any of [he items on [his fora.
<br />This mining operation may be used for less than 180
<br />days poi- year depending on local cainter conditions.
<br />To the best of ny knowledge, all [ha information pros en [ad in this applitacj~oti~i~ [roe
<br />and correct. /1 ~/(/./
<br />BY IY1 _
<br />T I TL E ~,~6/w/G~
<br />(~ignec by inJivi]ual ~_ all; ru[hor-
<br />irzd [o bind Lye cue n;or [o [his
<br />apGlication.j
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