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<br />-3- <br /> <br />11. Primary future (Poet-mining) land use (check one): <br />C~andICR) PaeturelandlPL) _ General Agriculture(GA) <br />g Rangeland(RL) _ Foreecry(FR) _ Wildlife Habitat(WL) <br />Residential (RS) _ Recreatron (RC) Industrial/Commercial (IC) <br />_ Developed Water ReeourceslWRl _ Solid Waste Disposal (WD) <br />12. Primary present land use (check one): <br />Cropland(CR) Pastureland(PL) General Agriculture(GA) <br />~, Rangeland(RL) _ Forestry (FR) _ Wildlife Habitat(WL) <br />Resrdential(RS) _ Recreation(RC) _ Industrial/Commercial(IC) <br />_ Developed Water Resources (WR) <br />13. Method of Minino: _ Quarry (QR) _ Solution (SO) <br />13.1 Other: Briefly explain mining method (e.g. Placer, tzuck/shovel). <br />Dozer. end loader <br />14. On Site Proceseino: Solution (SO) Chemical (CH) _ Thermal (TH) <br />_ Heap Leach (HL) _ Vat Leach (VL) <br />List any designated chemicals or acid-producing materials to be used or stored within <br />permit area: <br />hone <br />Descri n f Amendment: <br />If you are amen ing or converting an existing operation, provide a brief narrative <br />describing the proposed change(s). <br />Maps and Exhibits: <br />Five (5) complete, unbound application packages must be submitted. One complete <br />application package consists of a signed application form and the set of maps and exhibits <br />referenced belox ae Bxhibita A-S and the Geotechnical Stability Hxhibit. Hach exhibit <br />within the application must be presented as a separate section. Begin each exhibit oa a <br />nea page. Pages should be numbered consecutively for ease of reference. If separate <br />documents are used as appendices, please reference these by name in the exhibit. <br />with each of the five (5) signed application forms, you must submit a corresponding set <br />of the maps and exhibits as described in the following references to Rule 6.4 and 6.5: <br />S7G3IHIT A - Legal Description <br />HSEiIBIT B - Index Map <br />87G[IHIT C - Pre-Mining and Miaiag Plan Map(s) of Affected Lands <br />8%FiIBIT D - Mining Plan <br />6]GtIBIT 8 - Reclamation Plan <br />87OIIBIT F - Reclamation Plan Map <br />&]O[IHIT G - Water Information <br />IDQiIBIT H - Wildlife Information <br />fi]G{IBIT I - Soils Information <br />EXHIBIT J - Vegetation Information <br />SffiiIHIT K - Climate Information <br />HXHIBIT L - Reclamation Costs <br />H77OiIBIT M - Other Permits and Licensee <br />EXHIBIT N - Source of Legal Right-TO-Enter [See C.R.S. 34-32-112(2)(d)) <br />BXHIBIT O - Owners of Record of Affected Land (Surface Area) and Owners of Substance <br />to be Mined (See C.R.S. 39-32-112(2)(b) & (c)] <br />BXEiIBIT P - Municipalities Within Two Miles <br />EXHIBIT Q - Proof of Mailing of Notices to County Commissioners and Soil <br />Conservation District <br />EXHIBIT R - Proof of Filing with County Clerk and Recorder <br />H]CHIBIT S - (any required sections) <br />RIILS 6.5 - Geotechnical Stability 8xhibit <br />The instructions for preparing Exhibits A-S and Geotechnical Stability Exhibit are <br />specified under Rule 6.4 and 6.5 of the Mineral Rules and Regulations. If you have any <br />questions on preparing the 8xhibite or content of the information required, or would like <br />to schedule a pre-application meeting you may contact the Office at 303-866-3567. <br />