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I10 Permit Apnliea[ion (con ['d.) 14. Presan[ land use (i.e., agri- Sand and ravel excavati cultural, industrial, etc.) - 15~ Proposed future land use Sand and gravel excavation OI1 _ (Goal of reclamation) limited inpact scale L'B TRUC TI OTIS: This application and all accompanying materials must be submitted in duplica:e. In [he interests of efficient processing, please include [he follovaing inForina- tion & items. Limited Impact Operations, see °.U LE 3 for guida ice; Special 10- day Permits, sag RULE 4 for guidance. E XIIIBIT d - Lenal ne scriotion The legal de sc rip[ion must identify [he affected land and be wholly adequate for field location of [he grope rty. I[ can be in [he form of me [es L bounds survey or a description by reference [o [o•:rn ship, range, and section, [o a[ least [he nearest qua rter-q ua r[er section. '.+he re applicable, [he street add re 55 or lo[ number{s) may be used. EXHIBIT 6 - Mining Plan This can be a general discussion of the methods, equipment, phases or stages of [he o peratipn and th ase portions of land affected by each. The plan should be correl atcd :~ei th tna map and should show where extraction will begin, and which di rec[ion, if an}•, i[ will pros eed. E%H IBIT C - Mau This map should clearly define permit 6ounda ries and indicate all roads or stpckpile areal to be used in connection with the operation. All immedia [ely adjacent landowners must be shown. The quarter section corner, section line, or any other locate able points should also be shovm on this map. EXHIBIT D - Vildl fife, Voter P.e sou rtes. Vegetation and Soils Inforr'ati on Each of [he above-mentioned subj ec is must Se addressed as ou [l fined in the applicable RULE. EXHIBIT E - Reclamation Plan As with the mining plan, [his should he a general discussion of the methods, equipment, phases or stages of the reclamation process and [hose portions of land affected by each. If possibl=, [he plan should be closely correlated with [he moo. If not, the narrative must be comprehensive en ouch to draw an accurate verbal picture of [he expected appear- ance of [he area of ter ccmpletion of reclamation. EXH161T P -Proof of Local Government App royal This must Se a le[:er from the local government specifying conformance with existing zoning regulations. (It is intended that ope ra[o rs may obtain local government app royal wncu rren[ with the Division's processing of [he application. To do 50, the ope ra [or must submit evidence which indicates tnat Incal govt. app rpval :s currently pending or will a[ least Se considered within a reasonably short time bq [he app ropria[e governing body. .RULE I.I(10) (Consult this RULE for full de [ails on this repui re me n[.) E%HIBIT G - Source of Legal Right to Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. An acceptable al[e rna[ive would he a statement acknowledged by a notary public [ha[ the operator has the legal right to enter and mine. EXH 161T H - Re<lamati nn Costs !f the surety is requested to 6e less than $2500, the operator must submit facts to support such a reque s[. Otherwise, a sure [y of $2500 will automatically be set. **'• FOR SPECIAL 10-DAY (I11) PERMITS ONLY '~~~~ EXHIBIT I - Terms of Gove rnnental Cont roc[ For Special 10-Day (111) Permits, the operator must submi[ a copy of [he contra[[ or ether proof [hat proves the nee essiry of a special 10-gay permit. The operator must also submi[ evidence of the su~e[y provided under the governmental contract, if it was rag ui red. NfiTIfE P0.0C EDURES A `:er the application is considered "filed" (pursuant [o °.ULE I.I (10) r+i th :ne .Mined Land Reclamation Division, notice procedures outlined in RULES 3.2 G/or 4.2 must 6e followed. (Format For such notices :~i 11 6e included in the letter you receive frcm [he MLR staff informing you of [he completeness ("filing") of your applica[i on. ADD;T IOpAL fT1Fp P,MATI ON This space can be referenced for further info rma[ion of any of the items on this form. To [he best of my knowledge, all the information presen to 'in this application is [rue and correct. Y TITLE / %~d/~ Slone by ~diviJual legally author- ized [o bind [he operator [o this application.)