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<br />-z- <br />_ TYPE OR Pt~113F CLEARLY- -• ~.« <br />14. Present land use <br />=~lanri n3c+nrw lan(i <br />(i.e., agricultural, industrial, etc.) <br />15. Proposed future land use Drv land pasture <br />(Goal of reclamation) <br />INSTRUCTIONS: This application form must be submitted in duplicate and each form must <br />be accompanied by the following information and items. Tt~c application <br />will not be processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional guidance. <br />EXHIBIT A - Legal Description <br />The legal description must identify the affected land and be wholly adeyuate for <br />field location of the property. It can be in the form of metes and bounds survey <br />or a description by reference to township, range, and section to at least the <br />nearest quarter quarter section. Where applicable, the street address or lot <br />number(s) may be used. <br />EXHIBIT B - Mining Plan <br />This can be a general discussion of the methods, eyuipment, pleases or stages of <br />the operation and those portions of land affected by each. Tlie plan should be <br />closely correlated with the map and should show where extraction toill begin, which <br />direction it will proceed. <br />EXHIBIT C - Map <br />This map should be as comprehensive as possible in terms of clearly defining <br />the permit boundaries and indicaCing all roads or stockpile areas to be used in <br />connection with tine operation. A71 immediately adjacent landowners must be shown. <br />The closest quarter section corner, section line, or any other locateable point <br />should also be shown on the map. <br />EXHIBIT D - Wildlife, Water Resources, Veeetation and Soils <br />Each of the above-mentioned subjects must be addressed as outlined in the <br />applicable Rule, under it!~m number ten (10). <br />EXHIBIT E - Reclamation Plan <br />As with the mluing plan, this should be a general discussion of the methods, <br />equipment, phases or stapes of the reclamation process and those portions of <br />land affected by each. if possible, the plan should be closely correlated <br />with the map. If not, the narrative must be comprehensive enough to draw an <br />accurate verbal picture. of Clie expected physical appearance of the area after <br />completion of reclamation. <br />EXHIBIT F - Proof of Local Government Approval <br />This must be a letter from the local government specifying confnrnance with <br />existing zoning regulations. <br />EXl1IBIT G - Source of Lena7. Right to EnCec <br />This could be a copy of [lie lease, deed, abstract of tiC:Le, or cur.renC tax <br />receipt. In lieu thereof, a statement acknowledged by a notary public that <br />the operator has the 1et;aa rip,hr. to enter and mine. wil]. be ar_ccpCed. <br />**FOR SPECIAL 10-DAY PIiRi•fCTS ONT: t*i° <br />EXHIBIT ll - Reclamation Costs <br />If the surety is requested to be less than $2500, the operator muse submit <br />facts to support such request. Otl~erwlse a surety of $2500 will automatically <br />be set. <br />EXHIBIT I - Terms of Governmental Contract <br />The operator must submit a copy of the contract or other proof chat proves the <br />necessity of a special 10-day permit. The operator must also submit evidence <br />of the surety provided under tl~e governmental contract, if it was required. <br />