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~_ ~ Y , . • -2- O TYPE OR PRINT CLEARLY 1L. Prgent Lod ws - Cr•a wl A{* (L. a., agricultural, indw trial, e[c.) 1S. Proposed future land use Drv Rance LanA (Coal of reclamation) LNSTRUCTIONS: 1'hfs applteat ion form aunt be submitted !n dupllca to and each fors moat be accompanied by the following Sn[ormet ion and items. The spplleation will not be processed until complete. See RULE 7 (for LLited Iapaec) or RULE • (tor Special 30-day) for additional gu idamee. R101IBIT A - Legal Descrlpt ion The legal descrip tin cost Sdeotify the affected land and be wholly adegwte for field beat ion of t~,a property. It can be io the [on o[ metes and boumds survey or • description by reference to towship, range, and act ion to •t lust the nearest quarter gwrcar asst toe. Yhare appl Stable, the street sddresa or lot nwber (s) uy ba wed. t]OIIBIT 6 - MSninR Plam This can be • ganeul diseuuion of the cathode, equipment, phuas or stages of the operation and those portions of land affected Dy each. The plea should be closely correlated with the cap and should shoe where eztraet lom rill beglm, vhleb direcciom it viii proceed. DOIIBIT C - Map , This asp should be as eomprehenaiva as pose able 1m teroee of clearly defining ' the permit boumdarlea and indicating all roads or stockpile areas to W used Sn eonaection with the operas ion. All lmaed iscely ad]aeent lsndower• oust M show. Thc closest quarter sect ion corner, section lice, or any other loeatuble point O slwuld also be show on the up. CAIIBIT D - YSldlfte, Ye[er Resources, VeRetet ion and So 11• Infotwtlon Pesch oL the above-xnt coned aub~ects muse Ea addressed as outlined im tW applicable Rula, under Stec nwber ten (10). E[IRBIT E - Reclamation Plan As vich chc mining plan, tl,1s should be a general diseussioa o[ the rthods, equipment, phaaae or atagea of the reclamation process and those porcioma o! ' ~ land affected by each. If posaibla, the plan should be closely eornlated vich the map. If not, the narrative must be comprehensive amough to dray an aecursce verbal picture of the a:petted physical appearanes of the •rn after completion of reelaaation. EYIIIBIT P - Proof of Local (avernment Approval This wsc be • latter frog the lxal government speei[ying eonforawea with szleting toning resulaclona. l.101IBIT G - Source of Legal Risht to Enter This could be • copy of the leas, deed, abstuet o[ clue, or carom[ taz race lpt. Is lieu [hereof, a stacemenc seknwledged by • notary publ le that chc opera cot lua tl,e lessl right co enter and wine rtll M accepted. • eePOR SPECIAL 30-DAY PERMITS ONLYee C1fNI8IT U - Rec lasation Cosh I[ the ^urety is requested co be less than 51500, the oparater we subait facts co suppo[t wch reyueat. Otherwise • aunty of 52500 will autonatieally be sal. gYIIIBIT I - I'eta^ o[ Cove rmm~tal Cont nct ~``i, The opencor cwt subalc a copy of chs concoct or ocher prooL clot prows tM nsceuity of • apseial 10-day psrait. The operator wet also subalc widasee of cM surety provided under cM govsrarncal eomcraet, i[ is vu required.