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-4- 15. Description of Amendment or Conversion: If you are amending ar converting an existing operation, provide a brief narrative describing the proposed change(s): Maus & Exhibits: Submit two (2) complete, unbound copies of the following application exhibits: 6.3.1 EXHIBIT A -Legal Description and Location Map 6.3.2 EXHIBTT B -Site Description 6.3.3 EXHIBIT C -Mining Plan 6.3.4 EXHIBTT D -Reclamation Plan 6.3.5 EXHIBIT E -Maps, to include the location of any recorded easements 6.3.6 EXHIBIT F - List of Other Permits and Licenses Required 6.3.7 EXHIBIT G -Source of Legal Right-to-Enter 6.3.8 EXHIBIT H -Municipalities Within aTwo-mile Radius 6.3.4 EXHIBIT I - Proof of Filing with County Clerk 6.3.1 Ci EXHIBIT J - Proof of Mailing Notices of Permit Application 6.3.12 EXHIBIT L -Permanent Man-Made Structures 1.6.2(1)(b) ADDENDUM 1 -Notice Requirements (sample enclosed) 6.5 Geotechnical Stability Exhibit (as required) Res onsi ilities as a Perwittee: Upon application approval and permit issuance, this application becomes a legally binding doctmrent. Therefore, there are a mrmber of important requirements which you, as a permittee, should fully understand. These requirements are listedbelow. Please read and initial each requirement. in the space provided, to acknowledge that you understand your obligations. If you do not understand these obligations then please wntact this Office for a full explanation. ,~~ 1. Your obligation to reclaim the site is not limited to the amount of the financial warranty. You assume legal - liability for a4 reasonable expenses which the Board or the Office may incur to reclaim the affected lands associated with your mining operation in the event your permit is revoked and financial warranty is forfeited; ~~ 2. The Board may suspend or revoke this pemtit, or assess a civil penalty, upon a Ending that the permittee violated the terms or conditions of this permit, the Act, the Mineral Rules and Regulations, or that information wntainedmthe application or your permit misrepresent important material facts; ,~~ 3. If your mining and reclamation operations affect areas beyond the boundaries of an approved permit boundary, substantial civil penalties, to you as permittee can result; L~I 4. Arty modification to the approved miniug and reclamation plan from those described inyour approved application requires you to submit a permit modification and obtain approval from the Boazd or Office; 5. It is your responsibility to notify the Office of any changes in your address or phorre number;