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TYPE OR PRINT CLEARLY 14. Present land use Agriculture - Grazing of Livestock. (i.e., agricultural, industrial, etc.) 15. Proposed future land use Same (Goal of reclamation) IDTSTRUCTIONS:' This application form must be submitted is duplicate and each form must be accompanied by the following information and items. The application will not be processed until complete. See RULE 3 (for Limited Impact) or RULE 4 (for Special 10-day) for additional guidance. E7giIBIT A - Legal Description Tha legal description must identify the affected land and be wholly adequate far 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 nearaat quarter quarter section. Where applicable, the street address or lot number(s) may be used. E7TBIBIT 8 - Mining Plan Thin 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 map sad should show where extraction will begin, which direction it will proceed. ESHIBIT C - MoD This map should be as comprehensive as possible in terms of clearly defining the permit boundaries and indicating all roads or stockpile areas to be used in connection with the operation. A11 immediately adjacent landowners must be shown. The closest quarter section corner, section line, or any other loeateable point should also be shown on the map. ERHIBIT D - Wildlife, Water Resources, Vegetation and Soils Inforxation Each of the above-mentioned subjects must be addresse.i as outlined is the applicable Rule, under item number ten (10). E~IBIT E - Reclamation Plan Aa with the mining plan, this should be a general discussion of the methods, equipment, phases or stages of the reclamation pzocess sad chose portions of load affected by each. If possible, the plan shoul3 be closely c:orrelaced with the map. If pop, the narrative must be comprehensive enough to draw an accurate verbal picture of toe expected physical. anpnarance of the area after completion of reclamation. E7IIiIBIT F - Proof of Local Government Approval This must be a letter from the l.o..al government ape;at%ing cwtfocaaace with existing zoning regulations. E~I$IT G - Source of Le3a1 Ri~t_t to E.~tec This could be a cony of :..e lease tEnd, ~tb3t_ct at i. ~ c: _, u~ ,;•.;:reut tax receipt. III lieu t::erecf, d 9L. it'.iCnt e.t i:.:'+( `.^2C~ ~ry v m/ra"; pLLOli; Cl'-iiC the operator has the Legal =1ght :n ent~.r and r.,oe .111 '.,e accepted. **FOR SPECIAL 10-DAY PER2lITS 0?TT.Yt•~ E~IBIT 8 - Reclamation Costs If the surety is requested to be leas cyan S25U0, the operator must submit facts Co support such request. Other:+ise a surety of 52500 will autonaci;:ally be set. EYHIBIT I - Terns of Governmental Contract The operator moat submit a copy of the coutract or other proof that proves the neeesaity of a special 10-day permit. The operator must also submit evidence of the surety provided under the governmental contract, if it was required.