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'. 1 _. -2- TYPE OR PRINT CLEARLY 14. Present land use Grazing, Mining Operations Clay P~ (i.e., agricultural, industrial, etc.) 15. Proposed future land use Dry Range Land ~ (Goal of reclamation) INSTRUCTIOt?S: This application form must be submitted in duplicate and each form must be accompanied by the following information and items. The application will rot be processed until complete. See RULE 3 (for Limited Impact) or RULE 4 (for Special 10-day) for additional guidance. EXHIBIT A - Legal Description The legal description must identify the affected land and be wholly adequate for field location of the property. It can be in the forn of metes and bounds survey or a description by reference to to.vnship, range, and section to a[ least the nearest quarter quarter section. Idhere applicable, the street address or lot number(s) may be used. EXHIBIT B - ?3i,ning 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 closely correlated with the map and should show where extraction will begin, which direction it will proceed. EXHIBIT C - .`tap This map should be as comprehensive as possible in terms of clearly defining the permit boundaries and indicating all roads or sto:?;pile areas to be used in connection with the operation. All immediately adjacent lando•.mers must be shown. The closest quarter section corner, section line, or any other locateable point should also be shown on the map. EXHIBIT D - ?dildllfe. [dater Resources, Veleta*_ion and Sails Irformat Each of the above-mentioned subjects must be addressed as outlined in the applicable Rule, under item number ten (10). EX'rIIBIT E - Reclamation Plan As with the mining glen, t?:is 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 physical appearance of the area after completion of reclamation. EXHIBIT r - Pxoof of Local Government Approval . This must be a letter from the local government specifying conformance with existing zoning regulations. EtOiIBIT G - Source of Legal Right to Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. In lieu thereof, a statement acknowledged by a notary pub'_ic that the operator has the legal right to enter and mine will be accepted. **FOR SPECIAL 10-DAY PERt~SITS OILY°* EXHIBIT H - Reclamation Costs If the surety is requested [o be less than $2500, the operator must submit facts to support such request. Otherwise a surety of $2500 will automatically be set. EXHIBIT I - Terms of Governmental The operator must submit a copy of the contract or other proof that proves the necessity of a special 10-day permit. The operator must also submit evidence of the surety provided under the governmental contract, if it was required.