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~i <br />TYPE OR PRINT CLEARLY <br />~~ <br />l4. Present land use Aericulr.ur ra {nF of Liv s nck <br />(i.e., agricultural, industrial, etc.} <br />15. Proposed future land use ~G„mp <br />(Coal of reclamation) <br />IDTST&UCTIONS: This application form must be submitted is duplicate and each form must <br />' ba accompanied by the following information and items. Tha application <br />will not ba processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional guidance. <br />E7GtIBIT A - Legal Daserintion <br />Tha legal description must identify the affected land and ba wholly adequatn for <br />field location of the property. It can be iss the form of metes and bounds susnaq <br />or a description by reference to township, range, and section to at least the <br />aearut quarter quarter section. Sihere applicable, the street nddreas or lot <br />number(s) may be used. <br />1~IBIT B - Miaiaq Plan <br />This can be a general discussion of the methods, equipment, phases or etagaa of <br />the operation and those portions of land affected by each. The plan should ba <br />closely correlated with the map and should show where extraction will begin, which <br />direction it will proceed. <br />E7~IBIT C - Map <br />This map should ba as comprehensive as possible in terms of clearly defiaiag <br />the permit boundaries and indicating all roads or stocicpile areas to be used is <br />connection with the operation. A11 i~aediately adjacent landowners must be shown. <br />The eloeaat quarter section corner, section Line, or any other loeateable point <br />should also ba shown on the map. <br />E103IBIT D - Glildllfe, slater Resources, Vegetation and Soils Information <br />Each of the above-mentiaaed subjects must be addressed as outlined in [he <br />applicable Aule, under item number ten (10). <br />1~IBIT E - Reclamation Plan <br />As with the m:.ning place, this should be a general discussion of the~methoda, <br />equipment, phases or stages of the reclamation ptecess and Chose portions of <br />laced affected by each. If possible, the plan should be closely correlated <br />with the map. Zf nod, the narrative must be comprehensive enough to draw an <br />accurate verbal picture of the expected ;.hysicaJ. an?taranae of the area after <br />completion of reclamation. <br />EXHIBIT F - Proof of Local Government ,~pptoval <br />This must be a letter from the ].J„al g~,+C1.l:ntlliL ape.:ii;~.ag cunfora.,ace with <br />existing zoning regulations. <br />1~IBIT G - Source of Le3a1 R±~tt to F..~ts: <br />This could be a cony of „fna lease ~e_d, •,bat: .c_ at ~ u -, !e ..[teat tax <br />receipt. Ice lieu thereof, a sr..t~.:_nt rf:.~..~~.' ^.a. :y .. n,,rary public _i:at <br />the operator has the legal : iZ:.t ':r, e.^.:.~r aii.; ::, ne .:1! :.e accepted. <br />**FOR SPECIAL 10-DAY PER;iITS 0^i!.Y~ <br />~IBIT H - Reclamation Costs <br />If the surety is requesce,3 to be leas ct:an S't5U0, the operator must submit <br />facts to support such request. ~ther~rise a surety of $2530 trill sutoaaci::al'_y <br />be set. <br />F:{HI3IT I - lens of Goveromeacal Contract <br />The operator must submit a copy of the cautra.:t or other proof Chat proves Che <br />necessity of a special 10-day ?er:nlt. The operator must also submit evidence <br />of the surety provi~'ed u^ear cht governmental contract, if it vas required. <br /> <br />