PERMFILE100867

• Permit No: M1979148
• IBM Index Class Name: Permit File
• Doc Date: 8/10/1979
• Doc Name: LIMITED IMPACT 110 & SPECIAL 10 DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

1ln yermit Apvn ratier (<gne•d.}.._, __.~.~..~-. -- -`- = "----_-- -------°°-'- ^--,-
14. Pre stn[ IanO use (I-e., ag 1- -
cnllvral, Indust rl ul, etc.) ~J ~ a
15. Proppf<A future land use Range
(coal p( red ama[Ign) ~ .. .
- IIIS TRUCiICNS: This epPlicotion end ail accmp.n yang naieri Hs mv.[ be subni [t¢] in duplicate.
' In LSe in[e re scs o/ of (ICicn[ prn<essi nq, ple0te InclvJe the lollwing inforna-
Tlon L i[ens. Limited Impo<[ Ope raclens, see 4ULE J for guidance; Special 10-
Eay Pe rnti s, fee RULE 4 For guidance. ~ .
EXHIRIT A - Lrnal U^;c riotion ~- "~~ ~ --~~-~
the legal dewrlp N on cost idc ntily Ne alle cted land and be wholly adcquate /or
' li<Id location of the pros[ r[y. IC can be in [he form of vtm L bpunds survey
pr a description by «le recce to twnshio, rang.., and section, to at least the
newest qua n:er~c ua re<r sec<ian. Vnere appltoble, Lna t[rcet address or !o[
number(s) m+Y bq used.
EIHIRIT 9 - nin; np Pian
This can be s gore ral discussion o/ the me [hods, equipr. en[, phases or stages b( Lhe
ope ra [ion znd those pprciens or lani a/fect^_d by xach. The plan should be
correlated with Ne vap znA should shw where eat ra cci on wi 11 begin, and which
dlrec[ien, !f an Y, i[ will pros ecd.
E.TH IBIi C - nuo
. This map she old clearly dafi ne pa rr,it b0'andaries and indicate all roads ar stecRpile
areas to S< [fed in wnn<ction rich the <pa ration. dil irmediately adjac en[ ImdOwne rs
oust be shcrn. TM1e vuar;er si cti en corner, ;xc[ion line, or~any other Ic<a ceabl,: points
should also be shown on Nis map.
EXXIeIT p - pildli/e va to 0.asov«es, V¢re [scion and qoi H Informati cn ^
Each of [he ohm<-repcion ed subjects nest be addressed m Outlined in the applicable
RULE.
EItN IaIT E - Reclamation flan
' As wi to the min (nq elan, Nis sSOUid bu a yerteral d%s<ussi on of She methods, eduioment, ~
phaa es or s;aSes of the red amacien process and [hose pc rti ors of land offecced by each.
If possible, Ne plan snould be closely co rrelxtpd w~:h [he rap. If not, the narrative ~ '
must be coP.O rehensi ve enough to dram xn accurate verbal picture Of the anpec[ed appear- ,
ante of the arw •![er crnple[ien of «<Lvation.
EXH101T F - Trco1 of Lcul Lov<rnmene env ravel
Thfa rust b¢ a la Cer frm Na local acve rn¢mt ipe.iiy,nq con fona:nce .i :h a.la.i.y
ioning requlacicns. (It is intended that operators nay oo win local governren[ :pproYal
eon<urrent ric`~ the Di visl pr's prttessing of [he arplica[ion. Ta dp so, the operator '
" svst submit evi pence whirl indicates Nat Ipeal Sovt. zpo royal is currently oend(ng
or v;II ae lea sl Se vnsidered wi tnin a reasons Ely sho r; time by ;he apprepriata
gave rning body. .WLE I.I (10) (Consult this RULE !or full deeaiis On this requi remnt.}
EXH 191T G - Souru of-Legal 0.i ght to Enter
Ttia eeuld he a topY of the lease, dedd, abstract of dtrs, or currant tea rccalp t.
M acceptable al tsrna ti ve would be a sta ce•~ent acknowledged by • notary public that '
[he operator has the legal right to enter and mina.
EXH IeIT x - 0.e ciamaticn cos is
If the fu rats is reouesced to he toss then 52$00, the cpe ra[or wst submit /acts to
wPpo P[ sod a request. 0[ne n.i se, a surety pf 52500 .ill automsti ullY ba set. '
" sae FOR SPECIAL 10.OAY (III) PEiYITg OOLY ~+ '
~ fXHlelT 1 - erns of Governmental Contract '
for speei al 10-Oay (III) Termi es, the oparatar avs[ submit a copy pf the contract or
Other prop( that ?fovea the nec<ssi ty of a sped al 10-daY per~i [. The ove ra car must
. also subni[ evidence pf the surety provi dad vnaer the gowrnmen tai «n[racq if II was ~ '
regal red. '
~10T1[E PROCEDURES
. After chi spplieatlpn ff tarsi de red "filed" (Purl wan[ to RULE 1.1 (f O) ri th [he n(ned land ,
Recl aam ei on Divi sin, notice proccdurea outlined in RLLES 7.2 6/or 4.2 muff ba Fol iasmd.
(FOrvmC for suN noticca will ba included In the letter you receive frw [ha hLR staff
_ Informing you Of [he mnpleceness ("filing") of your aPplicati an.
AOOITIOIIAL IMfOM1 ATI ON
This space can be referenced /or /u rcher in(OrmeclOn o1 anY of Ne Itern rn eh if loan.
To Ne bese of mf Ivscwledga, all the Information preset [ed in this apvlica floc is trve
and wmcc. .- ~~
eT
. . - .. -. ... - . ~ TITLE E.T. II I
-- ~ iii gn<tl by indlr~dual legally ao[nmr-
' lied [o bind Lha epe ra [pr c0 [his