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<br />F <br /> <br /> <br />TYPE OR PRINT CLEARLY <br />14. Present land use Agricultural - Grazin <br />(i.e., agricultural, industrial, etc.) <br />15. Proposed future land use Same <br />(Goal of reclamation) <br />INSTRUCTIONS.,-' This application form must be submitted in duplicate and each form must <br />' be accompanied by the following information and items. The application <br />will not be processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional guidance. <br />E~iIBIT A - Legal Description <br />Tha legal description must identify the affected land and be wholly adequate for <br />field location of the property. It can be in the form of metes and bounds survey <br />or a description by reference to township, range, and section to at least the <br />nearest quarter quarter section. Where applicable, the street address or lot <br />number(s) may be used. <br />E7~IBIT B - Mining Plan <br />Thin eaa be a general discussion of the methods, equipment, phases or stages of <br />the operation and those portions of land affected by each. The plan should be <br />claaely correlated with the map and should shoe where extraction will begin, vhieh <br />direction it will proceed. <br />ESHIBIT C - MoD <br />This map should be as comprehensive as possible in *_erms of clearly defining <br />the permit boundaries sad indicating all roads or stockpile areas to be used in <br />connection with the operation. All immediately adjacent landowners must be shown. <br />The closest quarter section corner, section line, or any other laeateable point <br />should also be shows on the map. <br />ERHIBIT D - Wildlif e, Water Resources, VeRetatian and Soils Information <br />Each of the above-mentioned subjects moat be addresae3 as outlined in t:~e <br />applicable Rule, under item number ten (10). <br />E7~IBIT E - Reclamation Plan <br />As with Che mixing nlaa, this should be a general discussivn of the met!:ods, <br />equipment, phases or stages of the reclamation process sad chose portions of <br />land affected by each. If possible, the plan should be closely correlated <br />with the map. If nD~, the narrative must be comprehensive enough to draw an <br />accurate verbal picture of the expected physical. appearance of the area after <br />completion of reclamation. <br />E7UiIBIT F - Proof of Local Government approval <br />This must be a letter from the ].,..al goi~er.~menc ipe:;9t;~iag cu±ifvraaace with <br />existing zoning regulations. <br />E~IBIT G - Source of Legal Ri,~t,t to E.:ca; <br />This could be a copy of the lease iced, ?ba:::cc .~t .. c: ., „r c.~reuc tux <br />receipt. In lieu thereof, a st~r~:a~nt ;: r;:-:;•~'.~i^e1 ,y ~ n~;rar; puolit e:.at <br />the operator has the legal :igr.t cn Ps2ter a:zd :~.ae .;SL ~e accepted. <br />**FOR SPECLAL 10-DAY PER`lITS O:iLY''Rx <br />ERHIBIT 8 - Reclamation Casts <br />If the surety is requested to be leas ct:an S7.5U0, the operator must submit <br />facts to support such request. Otherwise a surety of 52500 gill aucocucically <br />be set. <br />E~IBIT I - Terms of Coverameatal Contract <br />The operator moat submit a copy of the contract or other proof that proves the <br />necessity of a special 10-day per:rlt. The operator must also submit evidence <br />of the surety provided under the go•rernmental contract, if it was required. <br /> <br />