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mainktined or public roads, bridges, wells, pipelines, water storage impoundments, railroad tracks, cemeteries, and <br />communication antennas. A narrative description must be provided in Exhibit B -Site Description; and <br />(fZ outline and label existing disturbance within and/or adjacent to the permit boundary (e.g., previously <br />mined azeas, roads or excavations resulting from utility construction). Re-disturbance of previously disturbed areas, by <br />the proposed mining operation, must be included in the permit area and addressed in Exhibit D -Reclamation Plan. <br />(3) Rrrlamatinn Plan Man <br />(a) show the gradient of all reclaimed slopes (horizontal:vertical) sufficient to describe [he post mine <br />topography; <br />(b) indicate where vegetation will tuv be established and the general area(s) for shrub or tree planting; <br />(c) if ponds are a part of the Reclamation Plan, outline the final shore configuration of the ponds and <br />shallow areas if the future land use is for wildlife; <br />(d) state the average thickness of replaced overburden by reclamation area or phase; and <br />(e) state the average thickness of replaced topsoil by reclamation area or phase. <br />FXA1731T F - i.ist of Other Permits and f.irences Ren~~ired_(Rulr fi_3.61~ Provide a statement identif}7ng which of <br />the following permits, licenses and approvals which are held or will be sought in order to conduct the proposed mining <br />and reclamation operations: e&7uent discharge permits, air quality emissions permits, radioactive source ma[edals <br />licenses, disposal of dredge and fill material (404) permits, permit to constmct a dam, well permits, State Historic <br />Preservation ice clearance, highway access permits, U.S. Forest Service permits, Bureau of Land Management <br />permits, county zoning and land use permits, and city zoning and land use permits. <br />RXAAtiT A - Snnrre of i.egal Right-tn-Enter (R~~Ir fi 3.'llc Provide a description of the basis for legal right of entry <br />to the site and to conduct mining and reclamation. This may be a copy of access lease, deed, abstract of title, or a <br />current tax receipt A statement by the Landowner and acknowledged by a Notary Public stating that you have the legal <br />right to enter and mine is also acceptable. <br />F.XR1RiT A - Mnnir~nalitiec Within a Two-Mile Radios (Role 6.3_Rl' List the mailing address and telephone <br />number of the governing body for all municipalities within a 2-mile radius of the proposed mining operation. <br />F.XAAAT f -Prnnf of Filinv with Cnnnt; Clerk (Rule fi_"t.91: Provide an affidavit or receipt indicating the date on <br />which the application was placed with the local County Clerk and Recorder. Also, refer to Rule 1.6.2(1)(c). <br />EXAAtiT .f -Prnnf of Mailing Notices of Permit Annliratinn t'Rn1r 63_tnl~ Include proof of mailings of the "Notice <br />of Permit Application" sent to the County Board of Commissioners and Board of Supervisors of the local Soil <br />Conservation District. in the application, by submitting the date-stamped receipt for Certified Mailing or adate-stamped <br />copy of the notice farm with signature acknowledging personal service and receipt by the appropriate board. Also, refer <br />to Rule 1.62(1)(a). <br />FXAITtiT I. - Permanent Man-Made Ctrnch~rec (Rule fi_3.721e YOU must provide information Suffteient t0 <br />demonstrate that the stability of any stmctures located within two hundred (200) feet of the operation or affected land <br />will not be adversely affected. If the Office determines that such information is inadequate to demonstrate that the <br />operation will not adversely affect the stability of any significant, valuable or permanent than-made simcture, the <br />Applicant shall either: <br />(a) provide a notarized agreement between the applicant and the person(s) having an interest in the <br />structure, that the applicant is to provide compensation for an}' damage to the structure; or <br />