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110 Pemi[ ,lo olicacion (con-) INSTR UCSIONS: T1~is application and all accompnnring matcrinls must be su Mni tied in duplicate. In Che interests of efficlant prn~essin5, plrasa includo Che fJllowin ~ :,: :.. ~. d _ _.._ ..,._-.+___ --_ v.,tv g intora' tr-,,. LL tc C~_.___-...., 3 for guidance; Special 10-day Permits ,+see RULE S for guidnnce.^^ EXHIBIT A - Legal Description She legal description must identify [he affected land and be wholly adequate for field location of the property. It can be in the form of metes b bounds survey nr a descrip- tion by reference Co township, range, and section, [o at least the nearast quarter- quarter section. Where applicable, the street address or Iot number(s) my be used. EXHIBIT B - "fining 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 shoe where extraction will begin, and vhich direct.Con, if any, it will proceed. EXHIBIT C - Map This map should clearly define permit boundaries and indicate all roads or stockpile areas co be used in connection with the operation. .111 immediately adjacent landowners must be shown. The quarter section corner, section line, or any other lot ateable points should also be shown on this map. EXHIBIT D -Wildlife, Water Resources, Vegetation and Soils Information Each of the above~eacioned subjects must be addressed as outlined in the applicable RULE. EXHIBIT E - Reclamation Plaa As with the mining plan, this should be a general discussion of the methods, equipment, pb.ases or stages of the reclamation process and those portions of land affected 6y each. It possible, the plan should be closely correlated vi th the map. If not, the narrative ' must be comprehensive enough co draw an accurate verbal picture of the expected appear- ac~ce of the area ai.ter completion of reclamation. EiRIBIT F - Proof of Local Government Approval This must be a letter from [he local government specifying conformance with existing soning regulations. (It is intended that operators may obtain local government approval concurrent vi th the Division's processing of the application. To do so, the operator rmist submit evidence vhich indicates that local government approval is cuttently pending o:' will at least be considered within a reasonably short time by the apprcpria[e govern- ing body RDLE 1.1(10) (Consult this RULE for full details on this requirement.) E1:HIB IT C - Source of Leal 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 statement acknowledged by a notary public that the operator has the legal right to enter and mine. E:OIIBIT A - Reclamation Costs For a 110 permit, if [he operator requests surety to be less than $2500, the operator must submit facts to support such a request. Otherwise, a surety of 52500 will automatically bye set. For all 112 permits, the surety shall be $2500 per acre. E:{HIBIS I - Terms of Cover[tmental 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 10-dap permit. The operator must a.L so submit evidence of the surety provided under the governmental contract, if iG vas squired. NOTICE PROCEDURES After the application is considered "filed" (pursuant to RULE 1.1(10) wi t}t the Mined Lind P.eclaaut'_cn Division, notice procedures outlined Ln RCL-c5 3.2 and/or 4.2 must be followed. (Form[ for such notices will be included in the letter you tec:e ive from the ~~L+.R staff informing you of the completeness ("filing") of your application. ADDITIONAL INFORSATION This space can be referenced for further information of any of the items nn this form. To the best of my knowledge, all the information presented in this applic:i[ion Ls true and correct. BY 6 ~ I TITLE Robert L. pad Supervisor (51;:^ca inLiviau;a !~ril1•: anCior_ iced [o, Sin _' t:w oparater W ['ifs r;,! _x.:_1.:.,.7