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110 Permit Application (cont'd)~ INSTR UCTI O!:S: This applLcation and all accompanying materials must be su Mnitted Ln duplicate. In the interests of efficient processing, pltasa include the olloving info ration ..~.,. ~_r..i tcd 1~. -. Ope:_ticne, .,ce O11_° 3 for guidance; Special 10-day Permits, see RULE ~4 for gu id a:~c e. E\HIBIT A - Legal Description The legal description must identify the affected land and be wholly adequate for fiellocation of the property. It can be in the form of metes 6 bounds survey or a descrip- tion by reference to township, range, and section, to a[ least the nearest quarter- quarter section. Where applicable, the street address or lot number(s) my be used. ERH IB IT B - Mining Plan This can be a general discussion of the methods, equipment, phases or stages of the operation and those portions of land affected by each. The plan should be correlated with the map and should show where extraction will begin, and which direction, if any, it will proceed. EXHIBIT C - Hap This map should clearly define permit boundaries and indicate all roads or stockpile areas to be used in connection with the operation. All immediately adjacent landowners must be shown. The quarter section corner, section line, or any other locateable points should also be shown on Chis map. EXHIBIT D - Wildlife, Water Resources, Vegetation and Soils Information Each of the above-mentioned subjects must be addressed as outlined in the applicable R[H.E, EXHIBIT E - Reclamation Plan As with the mining plan, this should be a general discussion of the methods, equipment, phases or stages of the reclamation process and those portions of land affected by each. If possible, the plan should be closely correlated with the map. If not, the narrative ` must be comprehensive enough to draw an accurate verbal picture of the expected appear- ance o£ the area after completion of reclamation. E:+'HIB ZT F - Proof of Local Government Approval This must be a letter from the local government specifying conformance with existing zoning regulations, (It is intended that operators may obtain local government approval concurrent with the Division's processing of the application. To do so, the operator must submit evidence which indicates that local government approval is currently pending or will at least be considered within a reasonably short time by the appropriate govera- ing body RULE 1.1(10) (Consult this Rl1I.E for full details on this requirement,) EXHIBIT G - Source of Legal Right to Enter This could be a copy of the"lease, deed, abstract of title, or current tax receipt. • An acceptable alternative would be a sta[eaent acknowledged by a notary public that the operator has the legal right to enter and mine. EXHIBIT H - Reclamation Costs For a 110 permit, if the operator requests surety [o be less than $2500, the ooeraternvst submit facts to support such a request. Otherwise, a surety of 52500 will automatica.ily be set. For all 111 permits, the surety shall be $2500 per acre. EXHIBIT I - Terms of Governmental Contracts For Special 10-Day (111) Permits, the operator must submit a copy of the contract or other proof that proves the necessity of a special 20-day permit. The operator must also submit evidence of the surety provided under the governmental contract, if it was required. NOTICE PROCEDURES After the application is considered "filed" (pursuant to RULE 1.1(10) with the Mined Land Reclamation Division, notice procedures outlined in RULES 3.2 and/or 4.2 must be followed. (Fcrnat _for such notices will be included i.n the letter yeu receive from the MLR staff inf ormirg you of [he completeness ("filing") of your application. ADDITIONAL Ih'FOR~SATION This space can be referenced for further information of any of the items on this form. To the b^s. of my knowledge, all the information presented in [his appl ration is tr[ie and correct. - . i / n J HN F. GLASS, SR. TI i"LS RNT (:T ASS 7 TVFSTf)~ CQ, T -(Si~n~,i i+c icci :~i ~a.~l 1:-~, ~iic a~u ho r-~ 1_ad CJ binJ t~On C~2 C.]Cnr CJ LIiiS