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12 Primary fntate (Post-mia~) 4ad ose (cheek one): <br />Cropland(CR) <br />Pasnnelsnd(PL) <br />General Agicuipue(GA) <br />~7 _Rangeland(RL) <br />Forestry(FR) <br />iRaidential(RS) _,Ra~oo(RC) <br />Developed wear Reswtrces(WRj <br />13. Prhnarv ntrsent land nx (check otse): <br />_Cropland(CR) _Pastumland(PL) <br /> <br />Residentiai(RS) _Raaeatioo(RC) <br />-Developed Wear Resoutrxs(VVR) <br />wildlife Hsbiat(WL) <br />~IndustriaVCommacral((C) <br />Solid Wasa Disposal(WD) <br />`General Agricultute(GA) <br />Wildlife Habitat(WL) <br />Ind~triaVCommercial(IC) <br />Solid Waste Disposat(9VD <br />14. If this operation will ose desig+aattd chemical4, or will resul4 or presently has acid mine drainage - <br />yoa cannot use this applicffiion foam. You mn~ subunit either a I lOd a 112d application fmm for <br />Designaad Mining Operations. In eit6~ cas4 you must list any acidic or toxiFfonning materials, <br />exposed or disturbed as s result of the mmmg operation, and whether the operatiat will result in or <br />presenty has acid mme drainage: <br />This ooaation will not use aqy of the deli chanicwls. The nit will not ntoduce acid mine <br />drainage. nor am taunt acid mine dtainaee. <br />15. I)eacrh>fioo of Amendment or Conversion: <br />If yon arc amending or oatvetYing sa exi~iog operating provide a brief naarative describing the <br />proposed change(s): This is a new ltatmit a»alit~4w. <br />lifaro do E><Iritiib: <br />Submit two (2) complete, wbouud copies of Nte following applicati~ exlubils: <br />6.3.1 FJCHIBIT A -Legal Description and Loceti~ Map <br />6.3.2 E)Q~IIBIT B -Sine Descriptie® <br />6.3.3 EXHIBIT C -Mining Plan <br />6.3.4 EXFIIBIT D - Reciamation Plan <br />6.3.5 - EXHIBIT E -Maps, to mch~e the location ofany recorded easements <br />b.3.6 E70lIBff F -List of Otiwv Permits aru! Liaoses Requirod <br />6.3.7 EXHIBIT G - Source of [,ege! Rigpt-to-Enser <br />6.3.8 EXHIBIT H - Municipnlitiea Wu6in a Two-mile Radius <br />6.3.9 EXFDBTi' I - Proof of Filing with Couuty Cleric <br />6.3.10 E7CIIIBIT J = Proof of Mailing Notices of Permit Application <br />6.3.12 EXHIBIT L - Pennarkot Man-Made Structures <br />1.6.2(lxb) ADDENDIJMI-NoticeRequiaemeMS(smnpkenclosal) <br />6.5 GeotecJmical Stability Exhbit (as requ"ved) <br />-5- <br />