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TYPE OR PRI?;T CL&9RLY 14. Present land use Wildlife Habitat. Clgy Pit (i.e., agricultural, industrial, etc.) 15. Proposed future land use Wildlife Habitat (Goal of reclamation) INSTRUCTi0i1S: This application form must be submitted in duplicate and each form must be accompanied by the following information and items. The application will rot be processed until complete. See RULE 3 (for Limited Impact) or RULE 4 (for Special 10-day) for additional guidance. EXHIBIT A - Legal Description The legal description must identify the affecte3 land and be wholly adequate for field location of the property. It can be in the form of metes and bounds survey or a description by reference to township, range, and section to at least the nearest quarter quarter section. kfi ere applicable, the street address or lot number(s) may be used. EXHIBIT B - Lining Plan This can be a general discussion of the methods, equipment, phases or stages of the operation and those portions of land affected by each. The plan should be closely correlated with the moo and should show cohere extraction will begin, which direction it will proceed. EXHIBIT C - Map This map should be as comprehensive as possible in terms of clearly defining the permit boundaries and indicating all roads or stoc!cpile areas to be used in connection with the operation. All immediately adjacent landowners must be shown. The closest quarter- section corner, section line, or any other locateable point should also be shown on the map. EXHIBIT D - Wildlife Water Resources Vegetation and Soils Inforrcaticn Each of the above-mentioned subjects must be addressed as outlined in the applicable Rule, under item number ten (10). EXHIBIT E - Reclamation As with the mining elan, tt:is should be a general discussion of the methods, equipment, phases or stages of the reclamation process and those portions of land affected by each. If possible, the plan should be closely correlated with the map. If not, the narrative must be comprehensive enough to draw an accurate verbal picture of the expected physical appearar_ce of the area after completion of reclamation. EXHIBIT F - Proof of Local Government Approval This must be a letter from the local government specifying conformance with existing zoning regulations. E.~LIBIT G - Source of Legal Right to Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. In lieu thereof, a statement acknowledged by a notary public that the operator has the legal right to enter and mine will be accepted. **FOR SPECIAL 10-DAY PER:IITS 02ILY~* EXHIBIT U - Reclamation Costs If the surety is requested to be less than $2500, the operator must submit facts to support such request. Otherwise a surety of $2500 will autonat'_ca11;~ be set. EXHIBIT I - Terms of Governmental Contract The operator must submit a copy of the contract or other proof that proves the necessity of a special 10-day permit. The operator must also submit evidence of the surety provided under the governmental contract, if it Baas required.