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<br />-3- <br />11. <br />Primacy future (Post-mining) load use (check one): <br />_ Craplaad(CR) _ Pasture}and(PL) <br />~ Rangeland(RL) _ Forestr~(FR) <br />_ Residential (RS) _ Recreatioa(RC) <br />_ Developed Water Resources(WR) <br />12. <br />Primary nreseat land use (check ane): <br /> <br />_ General Agriculture(GA) <br />_ Wildlife Habitat(WL) <br />_ Industrial/Commercial(IC) <br />_ Solid Waste Disposal(WD) <br />_ Croplaad(CR) _ Pastureland(PL) _ General Agriculture(GA) <br />X Raageland(RL) _ Forestry(FR) _ wildlife HabitatiWL) <br />_ Residential (RS) _ Re creation (RC) _ Industrial/COmmercial(IC) <br />_ Developed Water Resources (WR) _ Mining (MN) <br />13. If this operation will use designated chemicals, or will result, or <br />presently has acid mine drainage - you cannot use this application <br />foam. You must submit a either a 110d or 112d application form for <br />Designated Mining Operations. In either case, you must list any <br />acidic or toxic-forming materials, exposed or disturbed as a result of <br />the mining operation, and whether the operation will result in or <br />presently has acid mine drainage: <br />N!A <br />Description of Amendment or Conversion: <br />If you are amending or converting an existing operation, provide a brief <br />narrative describing the proposed change(s). <br />Mans & Exhibits- <br />Sub®it TWO (2) complete, unbound copies of the following application <br />exhibits: <br />6.3.1 <br />6.3.2 <br />6.3.3 <br />6.3.4 <br />6.3.5 <br />6.3.6 <br />6.3.7 <br />6.3.8 <br />6.3.9 <br />6.3.10 <br />6.1.2 (1) (b) <br />6.4.19 <br />6.5 <br />SXHIBIT A - Legal Description and Location Map <br />HICHIBIT B - Site Description <br />SXHIBIT C - Mining Plan <br />SXHIBIT D - Reclamation Plan <br />SXHIBIT S - Maps <br />SREiIBIT F - List of Other Permits and Licenses Required <br />SXHIBIT G - Source of Legal Right-to-Enter <br />EXHIBIT H - Municipalities Within a Two-mile Radius <br />EXHIBIT I - Proof of Filing with County Clerk <br />EXHIBIT J - Proof of Mailing Notices of Permit Application <br />ADDENDUM 1 - Notice Requirements (sample enclosed) <br />EXHIBIT S - (as required) <br />Geotechnical Stability Exhibit (as required) <br /> <br />