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+ .~ ~• .~. <br />• TYPE OR PRINT CLF~RLY • <br />14. Present land use Rangeland <br />(i.e., agricultural, industrial, etc.) <br />15. Proposed future land use Rangeland <br />,(Goal of reclamation) <br />INSTRUCTIONS: This application form must be submitted in duplicate and each form must <br />be accompanied by [he following information and items. The application <br />will not be processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional guidance. <br />EXHIBIT A - Legal Description <br />The legal description must identify the affected land and be whol'_y adequate fcr <br />field location of the property. It can be in the form of metes and bounds survey <br />or a description by reference to township, range, and section to at least the <br />nearest quarter quarter section. S,There applicable, the street address or lot <br />number(s) may be used. <br />EXHIBIT B - .Lining Plan <br />This can be a general discussion of the methods, equipment, phases or stages of <br />the operation and those portions of land affected by each. The plan should be <br />closely correlated with the map and should show where extraction will begin, which <br />direction it will proceed. <br />E.XfiIBIT C - Map <br />This map should be as comprehensive as possible in *_eras of clearly def fining <br />the permit boundaries and indicating all roads or stockpile areas to be used in <br />connection with the operation. A11 itm:ediately adjacent landowners :oust be shown. <br />The closest quarter section corner, section line, or any other lccateable point <br />should also be shown on the sap. <br />E.~IIBIT D - Tdildlife, Water Resources, Vegetation and Soils Infornati:~n <br />Each of the above-mentioned subjects must be addressed as outlined in the <br />applicable Rule, under item number ten (10). <br />~I3IBIT E - Reclamation Plan <br />As with the mining plan, this should be a general discussion of t:he methods, <br />eouipment, phases or stages of the reclamation process and those portions of <br />land affected by each. If possible, the plan should be closely <:orrelated <br />with the map. If not, the narrative c,ust be comprehensive enough to drama an <br />accurate verbal picture of the expected physical appearance of tt:e area after <br />completion of reclamation. <br />~iIBIT F - Proof of Local Government ADDIDVaI <br />This must be a letter from the local gover.~.nent specifying confo::aance with <br />existing zoning regulations. <br />E`;~ZBIT C - Source of Legal P~ght to ?nter <br />Tnis could be a copy of the lease, deed, abstract of title, or clrrert tax <br />receipt. In lieu thereof, a statement ac!cnowledged by a notary public that <br />[he operator has the legal right to enter and mine will be accepted. <br />**FOR SPEC7at. 10-DaY PEPu~1ITS O:dLY** <br />E.~iIBIT H - Reclamation Costs <br />If the surety is requested to be less than $2500, the operator Gust subnit <br />facts to support such request. Otherdise a surety of $2500 will automatically <br />be set. <br />ESFiIBIT I - Terns of Governmental Contract <br />The o^er=ter rust submit a copy of the contract or other proof that proves the <br />.. ~;. ~.; ~~_~ Cf ... _____l ~n-'~_" __-~{r. '~,~ nncT-~hnr ,~itSt alGO SL.Dmit evidence <br />of the =+iret;~ provided under the governmental contract, if it was required. <br />