REV05539

• Permit No: M1989029
• IBM Index Class Name: Revision
• Doc Date: 9/21/2000
• Doc Name: CONSTRUCTION MATERIALS - REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM3
• Media Type: D
• Archive: No

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li. Description of Amendment or Comenion:
If you are ame¢diog or converting an existing operatio¢, provide a brief ¢arrative describing the proposed chance(s).
This amendment requests the a 7t)on f 239.4 acres of leased land to the
existing permit. No change in mining or processing methods is proposed.
Mans and Exhibits
Five (5) complete. unbound application packages must be submitted. One complete application package consists of a sipped application form
and the set of maps and exhibits referenced below a; Exhibits A-S, Addendum 1, and the Georech¢ical StabiliR• Exhibit. Each exhibit withi¢
[he applcation must be presented as a sepazate secilo¢. Begi¢ each exhibit on a new page. Pages should be cumbered co¢secutiv'eh~ for case
of reference. If sepal ate documents are used as appendices, phase reference these b}~ came in dte exhibit.
With each of the five (5) signed application forms, you must submit a corresponding set of the maps and exhibits as described in the follovcinp
references to Rule 6.d. 6.5, and 1.6.2(1)(b):
EXHIBIT A Legal Description
E.XTIIBIT B Index Map
EXHIBIT C Pre-Mining and Miwug Plan Map(s1 of Affected Lands to include the location of any recorded easements
E.X]-IIBIT D Mining Plan
EXF-IIBIT E Reclamation Plan
Ea"FfJBIT F Reclamation Plan Map
EXIIIDIT G Water Information
EXHIBIT H Wildlife Information
EXHIBIT I Soils Information
E7~'I-IIBIT J Vegetation Informatiou
EXHIBIT K Climate Information
EXI118[T L Redamatio¢ Costs
EXHJB(T M Other Permits and Licenses
EXIIIBIT N Source of Legal Right-To-Enter, to include holders of any recorded easements
EXHIBIT O Owners of Record of Affected Laad (Surface Area) and Owners of Substance to be Mined, to include
holders of anv recorded easements
EXI-IIBIT P Municipalities Within Two Miles'
EXHIBIT Q Proof of Mailing of Notices to Counrv Commissioners and Soil Conservatio¢ District
EXHIBIT R Proof of Filing with County Clerk or Recorder
£XI QB1T S Permanent Man-Made Structures
Rule 1.62(l)(b) ADDENDUM 1 -Notice Requvements (sample enclosed)
Rule 6.5 Geotechnical Stability Exhibit (any requ'ved sections)
The wstructions for pnparing Exhibits A-S, Addeudum I, and Geotechnical Stability Exhibit are specified under Rule 6.d a¢d 6.5 and Rule
1.6.2(l)(b) of the Rule:. and Regulations. [f you have any questions o¢ preparing the Exhibits or content of the wformation required or would
like to schedule apre-application meeting you may contact [he Ofltce at 303-866-3567.