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• -3- ~ • <br />11. Primary future (Poet-mining) land uee (check one): <br />_ CC=opIaad(CR) _ Pasturelaad(PL) General Agriculture(GA) <br />~, Raa9eland(RL) _ ForestrY(FR) _ Wildlife Habitat(WL) <br />Residential(RS) Recreation(RC) Industrial/Commercial(IC) <br />_ Developed Water Reaourcea(WR) _ Solid Waste Disposal(WD) <br />12. Primary present land use (check one): <br />Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA) <br />~ Rangeland(RL) ForeatrylFR) _ Wildlife Habitat(wL) <br />Resrdential(RS) = RecreatronlRC) _ Lndustrial/Ccam~ercial(IC) <br />_ Developed Water Resources(WR) <br />13. Method of Mining: ~ Quarry (QR) _ Solution (SO) <br />13.1 gther: Briefly explain mining method (e.g. Placer, truck/shovel). <br />14. On Site Processing: Solutiaa (SO) Chemical (CH) _ Thermal (TH) <br />_ Heap Leach (HL) _ Vat Leach (VL) <br />List any designated chemicals or acid-producing materials to be used or stored within <br />permit area:- <br />Pl„ ~1, <br />Descri tion of Amendmen <br />If you are amen rag or converting an existing operation, provide a brief narrative <br />describing the proposed change(s). <br />Ma s and Bxhibits• <br />Five 5 comp ete, unbound application packages must be submitted. One complete <br />application package consists of a signed application form and the set of maps and exhibits <br />referenced belox as 8xhibita A-S and the Geotechaical Stability Exhibit. Rach exhibit <br />xithia the application must be presented as a separate section. Begin each exhibit on a <br />nex page. Pages should be numbered consecutively for ease of reference. if separate <br />documents are used as appendices, please reference these by name in the exhibit. <br />with each of the five (5) signed application forms, you must submit a corresponding set <br />of the maps and exhibits as described is the folloxing references to Rule 6.4 and 6.5: <br />fiffiiIBIT A - Legal Description <br />S1GiIBIT B - Index Map <br />HXHIBIT C - Pre-Mining and Mining Plaa Map(s) of Affected Lands <br />fiSEiiZBTT D - Mining Plan <br />fi70iIBIT 8 - Reclamation Plaa <br />6~DiIBIT F - Reclamation Plan Map <br />fi7QiIBTT G - water Information <br />ElOIIBIT H - Wildlife Information <br />&%FiIBIT I - Soils Information <br />BRHIBIT J - Vegetation Information <br />&XHIBIT K - Climate Information <br />fi7GiIBIT L - Reclamation Costs <br />SX1iIBTT M - Other Permits and Licenses <br />S7giIBIT N - Source of Legal Right-To-Hater [See C.R.S. 34-32-112(2)(d)) <br />S70iIBIT 0'- Owners of Record of Affected Laad (Surface Area) and Owners of Substance <br /> to be Mined [See C.R.S. 34-32-112(2)(b) ~ (c)] <br />filQ3IHIT P - Municipalities Within Txo Miles <br />&7QiiBIT Q - Proof of Mailing of Notices to County Commissioners and Soil <br /> Conservation District <br />&70IIBIT R - Proof of Filing xith County Clerk and Recorder <br />fiXFiiHIT S - (any required sections) <br />RIILfi 6.5 - Geotechnical Stability 8xhibit <br />The instructions for preparing Bxhibits A-S and Geotechaical Stability Hxhibit are <br />specified under Rule 6.4 and 6.5 of the Mineral Rules and Regulations. if you have any <br />questions on preparing the 8xhibita or content of the information required, or would like <br />to schedule a pre-application meeting you may contact the Office at 303-866-3567. <br />