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110 Petnit Aoolication ~cant'd) I'.tSTRUCTI0:;5: This application and all accanpam•Ln¢ materials must 6e su tnni tted Sn duplicate. Ln the f.nterests o: affici~~t ?rocessin;, ,.L.asa .a~...de C~c the following Sn:ar;a- r ..-r L'r.itcd '- .-._cc^ .._- °_12H 3 for guidance; Spec:1a1V10-day~Permits, see RULE + for guidance.^^ &'CHZ9IT A - Lezal Description 'fhe legal description must identify the affected land and be wholly adequate for field location of. the property. It can kle in the form of metes b bonds survey or a descrip- tion by raf:erence to cowship, ranp;e, and section, to at least the nearest quarter- quarter section. 4here applicable„ the street address or lot number (s} my be used. E.TEIBIT B - Ninin¢ Plan This eaa be a general discussion oi: the methods, equ'-pment, phases or stages of the operation and those portions of Iarui affected Sy each. 'the plan should be correlated with the map and should shoe where eztraetion will begin, and which direction, if any, it will proceed. ERHIBLT C - `Sao This map should clearly define permit boundaries and indicate all roads or stockpile areas to 6c used La conaeecivn with the operation. .1.11 immediately adjacent laadowers muse be show. the quarter section comer, section line, or any ocher locateable points should also be show on this map. ERHIBIT D - Wildlife, Water Resources. Vezetation and Soils Information Eae6 of chr. above-mentioned subjects c¢sat ba addressed as outlined is the applicable RUIZ. ~IBIT E -Reclamation Plaa As with too mining plan, this shou:Ld be a general diseua3iou'of the methods, equipment, phases or stages of the reclamation process and those portions of land affected by each. If possible, the plow should be clus~.y, correlated with the map. If not, the oarrative. must be ev3prehensive enough co draw ~ accurate verbal picture of the expected appear- ance of the area af.eer complatioa of reclamation. r?SL92'_' F - ?roof of Local Cavarnmeat Approval 'this must be a Letter from the loe.al government specifying conformance with existing zoning regulations. (T-t is intended that operators may obtain local government approval concurrent with the Division's pro~tessiag of the application. To do so, the operator must submit evidence which indicates chat local government approval is currently Dendiag or will at least be considered vit:ala a reasonably short time by the appropriate govern- ivg body ROLE 1.1(10) (CansuLt this RULE for full details on this requirement.) _3HIDIT G ~- Source of Leal Ri¢ht to Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. Aa acceptable alternative would be a statement ackavvledged by a notary public that the operator has the legal right co eater and mine. E:QiIBIT H - Reclamation Costs tar a IIO permit, if the operator requests surety to be less Clan $?500, the ooeratormuse submit facts to support such a ree~uesc. Otherwise, a surety of 52500 will automatically be set. For all 111 permits, the surety shall be 52500 per acre. IT I - Terms of Governmental Contracts For Special 10-Day (121) Yermi es, the operator must submit a Copy of the contract or other proof that proves the neeassity of a special LO~ay permit. The operator must also submit evidence of the surety provided under the govasnmencal contract, if Lt vas required. NOTZCE PROCEDURES after Cha application is considere3 "filed" (pursuant to RULE 1.1(10) with the `lined Iand Rec'_amacian Division, no cite procedures outlined is RDLES 3.2 sad/or 4.2 mist be fo1'--owed. (Format for such notices will be included in the letter you receive from the }II.R staff infoxaing you of the completeness ("filing") of your application. .ADDITIONAL IPIFORv.ATION :his space can be referenced for Further iaformacioa of any of the items on this form. To t::e best of my knowledge, all the information presented in this application !: true and correct. BY ~_~, _rT._ ~, (>1, ':'~ ~" 1!til:'idU,:k ~ ~_]k~:: .yli:IJt- L-2;i .. .:p] ..~ Ca2Ca COr tJ C::!i ... •