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-Z- <br />TYPE OR PRINT CLEARLY <br />le. Preaeoc land uea Agricultural - Wildlife <br />(l.e., agricultural, Lnduaerial, tee.) <br />15. Proposed future land use Wildlife habitat, dry range land <br />(Goal of reclamacfo n) recreational <br />INSTRUCTIONS: Thin appLieatiom form mute be auhmleced Ln duplicate end each Eorm must <br />be aeeompemied by cha fo !loving Lnta nation and items. Tha appLlcaclpn <br />will not 6e processed until conpleca. See RULE 1 (for Lim1 [ed Impart) <br />or gULE G (tor Spacial 10-day) far additional guidance. <br />EE}IIB IT A - Legal Deacrlp clan <br />The legal daa cripcice must SdeneLfy the a£fecced Land and be wholly adequa to for <br />field lo~~cloa of the property. It can ba !n the form of ma tea and bounds survey <br />or a deaerlpeion by ce Cerenu co towahlp, tango, and aaetlon co ac Luat cha <br />nearest quarter qua rest aacelom. Nhere appllcab la, cha street addreaa or Lot <br />number(s) may be ua ed. <br />E)O1IB Ii B - Ytnlog 21an <br />ThSr ern b~ ~ general die cuss ion of cha meehMa, equ ipmenc, pheaea or acagea of <br />the opera[ ion and chaos po rtiona of Land affected by each. Tha plan should b:• <br />cloenly torLPla red :~1 Ch [he map and should ahoy where extraction will begin, vl,Lch <br />dlcec[i.o,. 1t rill proctxd. <br />E~IB IT C - !tar <br />This nap should ba as comp rehenalva as pate lb le in terms of clearly def Sning <br />the pe colt boundaries and indite Clog all rmada ar atoef<p[le areas to be used Lo <br />toaneccion uich the operation. AL1 Lamed is rely ad]acent landounera moat be show. <br />Ths cloaeac quarter section corner, sect ion Line, or any ocher Locateable po ins <br />.~ <br />should also ba ahcvn on cha yap. <br />f]OlIBLT D - I711d11f e, aster Reaaurcea, Veneta elan and So Lla InCormatlon <br />Each of the above-mentioned euh]ecta moat Sa addr ea aed as outlined in the <br />applicable Rule, under Lcem number tan (10). <br />E~IBIT E - Reclameedon Plan <br />A• uich the minLng plan, ch is should 6e a general diaeuaaioa of the ma thoda, <br />equipment, pheaea or acagea of the re clsmaeiao proceed and chose pmrtioaa at <br />land offer cad Sy each. IC poesf6le, the play should be closely correlated <br />u lth the map. Cf not, the nacres iva moat be camp r~hemive enough to drau an <br />accurate ve rhal pLc CUCe of Cha azpecced phyalcal appearaa ce aC the area aC ter <br />completion of raclamat Lon. <br />E~QtIBlT P•- Prpof oC Local Gove rnmenc Approval <br />This mu:e be a~lac ter fros cha lot al governnant apeclEying conforaaace with <br />a:lacing zoning requla [lone. <br />P.XtlIB IT C - Source of Legal 4daht to Enter <br />ThL could be a copy at the Lease, deed, aba cr net of title, or current tea <br />receipt. Ln lieu therea C, a atacemenc acknorledged by t no Cary pub Llc that <br />[ha operator has the legal right to en cec and acne will be aecepead. <br />eaFOB SPECLAL 10-OAY PERNIiS OYLTi1 <br />EQfI62T B - Reclamation Coaea <br />I£ [ha surety Ss requested to 6e lees than 52500, Cha operator moat submit <br />Eacta co auppo t[ such request. Oche rv Laa a aure[y of 52500 will automatically <br />6e net. <br />ERBLB LT L - Terms of Covarnmeatsl Contract <br />Ttte operator auac au6mlc a copy of cha too cr arc mr ocher proof that proves the <br />naeeaslcy of a epee lal 10-day permit. The operator muse also submit evidaoce <br />oC cha surety provided under cha governmental rooster e, if St van required. <br />