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-4- 12. Priman• furore (Post-mining) land use (check onN: _ Cropland(CR) X Pastureland(PL) _ Rangeland(RL) _ Forestn~(FR) _ Residential(RS) _ Recrea[ion(RC) Developed WaterResources(WR) 13. Priman• present land use (check one): _ Cropland(CR) ~ Pastureland(PL) _ Rangeland(RL) _ Forestn-(FR) _ Residential(RS) _ Recreation(RC) Developed Wa[erResources(WR) Geneml Agriculture(GA) _ Wildlife Habitat(WL) _ IndustriaUCommercial(IC) Solid WasteDisposal(WD) _ General Agriculture(GA) WildlifeHabitat(WL) _ Indus[riaUCommercial(IC) _ Mining (MN) 14. If this operation will use designated chemicals, or n•ill msuH, otpresentlc has acid mine dminage - }~ou cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic ortoxic-forming materials, exposed or dismrbeA as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: W1LL par 6C (~5~~ 15. Descrinton of Amendment or Com•ersion: If you are amending or converting an Maos & Exhibits: operation, provide a brief narrative describing the proposed change(s): Submit two (2) complete, unbound copies ofthe following application exhibits: 63.1 EXHB[T A -Legal Description and Location Map 6.3.2 EXHIBIT B -Site Description 633 EXHIBIT C -Mining Plan 63.4 EXHIBIT D -Reclamation Plan 63.5 EXHIBIT E -Maps, to include the location of any recorded easements 63.6 EXHIBIT F -List of Other Permits and Licenses Required 63.7 EXHIBIT G -Source of Legal Right-to-Enter 63.8 EXHIBIT H -Municipalities Within a Two-mile Radius 63.9 EXHIBIT I - Proof of Filing with County Clerk 63.10 EXHIBIT J - Proof of Mailing Notices of Permit Application 63.12 EXHIBIT L -Permanent Man-Made Structures I.6.2(ixb) ADDENDUM I -Notice Requirements (sample enclosed) 6.5 Geotechnical Stability Exhibit (as required)