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^~ •..3 -3- ~~ 11. Primary future (Post-m;n;nq) land use (check one): _ Crvpland(CR) _ Pasturelaad(PL) _ General Agriculture(GA) ~ Raageland(RL) _ Forestry(FR) _ Wildlife 8abitat(WL) _ Resideatial(RS) _ Reczeatioa(RC) _ IndustrialjCoc®ercial(IC) _ Developed water Resources (WR) _ Solid Waste Disposal (WD) 12. Primary present land use (check one): Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA) ~( Rangelaad(RL) _ Forestry(FR) _ Wildlife 8abitat(WL) _ Residential(RS) _ Recreatioa(RC) _ Industrial/Commercial(IC) _ Developed water Resources (WR) _ Mining (PffQ) 13. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit a either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the m;ning operation, and whether the operation will result is or presently has acid mine drainage: No toxic £ormino or acidic materials. pescription of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief n~~tive describing the proposed change(s). Maus & Exhibits: Submit Two (2) complete. unbound copies of the following application exhibits: 6.3.1 6.3.2 6.3.3 6.3.4 6.3.5 6.3.6 6.3.7 6.3.8 6.3.9 6.3.10 6.1.2(1) (b) 6.4.19 6.5 EXHIBIT A - Legal Description and Location Map EXHIBIT B - Site Description EXHIBIT C - Miaiag Plan EXHIBIT D - Reclamation Plan ESSIBIT E - Maps B~IBTT F - List of Other Permits and Licenses Required EXIiIBIT G - Source of Legal Right-to-Eater EXHIBIT H - Municipalities Within a Two-mile Radius EXHIBIT I - Proof of Filing with County Clerk EXHIBIT J - Proof of Mailing Notices of Permit Application ADDENDDM 1 - Notice RequirP*nP*+ts (sample enclosed) EXHIBIT S - (as required) Geotechnical Stability Exhibit (as required)