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<br />19. The lands herein do not affect any of <br />the lands described in Section li5(4)(f) <br />of the Mined Land Reclamation Act. <br />(Soecifv affirmation) <br />These subject mined lands do not affect <br />any of the land described in Section <br />115 (4) f. <br />MAPS ~ EXHIBITS <br />With each of the five (5) copies of the application form, the applicant must submit <br />a corresponding set of the maps and exhibits outlined in RULE 2, as follows: <br />1. EXHIBIT A - Legal description <br />2. EXHIBIT B - Index map <br />3• EXH131T C - Pre mining b mining plan map(s) of affected lands <br />~. EXH131T D - Mining plan. <br />5• EXP,IBIT E - Declamation plan <br />6. EXHIBIT F - Reclamation plan map <br />7. EXHIBIT G - Water information <br />S. E:(HIBIT ii - Wildlife information <br />3• E;tHIBIT I - Soils information <br />10. EXHIBIT J - Vegetation information <br />11. EXHIBIT K - Climate <br />12. EXHIBIT L - Raclamaticn Costs <br />NB: Concerning the next three EXHIBITS M, N, 0: please note that the <br />_ July 1978 edition of the Rules and Regulations omits thhese EXHIBITS. <br />This was not a deletion by the "fined Land P,eclamation Board; the <br />-' data required from these E(HIBITS was merely transferred to a neti•+ <br />_ section in the P.eguiations (RULE 9, p. 4b). Subsequent issues of the <br />_ Regulations will reflect the omission of proper cress-referencing in <br />this regard. Please include, in ycur permit application, EXHIBITS <br />_ M, N, 0, as required by RULE 9.1(1), (2) and (31• <br />13• EXH13lT tl - Local government approval ) See F'JLc 9.1(1) <br />14. EXIiiDIT N - Daher permits or licenses None ) See PULE 9.112) <br />IS• EXHIBIT 0 - .Source of legal righ*_ to enter } See RULE 9.1(3) <br />10. EXH131T ° - Owners of record of surfa<e and subsurface rights. <br />J.H. Lionelle---Dept. of the Interior (B.L.M.} <br />See Exhibit 'C'. <br />FIOTICE PROCEDUP,ES <br />After the application is considered "filed" (pursuant to RULE 1.1(10) .•rith the <br />?lined Land Reclamation Division, notice procedures outlined in RULE 2.2 must be <br />follcwed. (Format for such notices will be included in the letter you receive from <br />the MLR Staff informing you of the completeness ("filing"} of your application. <br />ADDITIONAL IhIFOR1'PTiG.1 <br />This space can be referenced for further information of any of the items in this form. <br />To the best of rry knowledge, all the information <br />true and correct. ! ,G' <br />BY c <br />Tlr~ <br />:d in/YFii~/applicaCion is <br />r //a <br />(Signature by individual legally authorized to bind <br />the operator to this application.) <br />I <br />j <br />