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• <br />-2- <br />TYFL•' OR PRIM' CLEAFZLY <br />14, Present lan3 use <br />C;ra~in~ T.a nri <br />(i.e., agricultural, industrial, etc.) <br />15. Proposed future land use Grazing Land <br />(Goal of reclamat.ton) <br />INSTRUCTIONS: This application form must be submitted in duplicate and each form must <br />he accompanied by the following information and items. The applicatlon <br />will not be processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional Suidance. <br />EXHIBIT A - Le{;al Uescrip[ion <br />The legal description must identify file affected land and be wholly adequate for <br />Held location of ttre 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. tJhere applicable, the street address or lot <br />number(s) may be used. <br />EX}tIBIT H - Mining Plan <br />This can be a general discussionr of ttre methods, equipment, phases or stages of <br />the operation and those portions of land affected by each. The plan should be <br />closely correlated with the map and should show where extraction will begin, which <br />direction it will proceed. <br />EXSIIBIT C - Map <br />This map should be as comprehensive as possible in terms of clearly defining <br />the permit boundaries and indicating all roads or stockpile areas to be used in <br />connection with flee operation. All immediately adjacent landowners must be shown. <br />The closest quarter section corrrer, section line, or any ottrer locateable point <br />should also be shown on fire map. <br />EXHIBIT D - Wildlife, Water Resources, Yeeetation and Soils Inf <br />Each of the above-mentioned subjects must he addressed as outlined in tare <br />applicable Rule, under item numher ten (1C). <br />EXHIBIT F. - P.eclamation Plan <br />As with the mining plan, this should be a general discussion of the methods, <br />equipment, phases or stages 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 the e:cpected 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 conformance with <br />existing zoning regulations. <br />EXHIBIT C - Source of Leeal Richt to Enter <br />This could be a copy of flee lease, deed, abstract of title, or current tax <br />receipt. In lieu thereof, a statement acknowledged by a notary public that <br />the operator leas [he lesal right to enter and mine will be accepted. <br />**FOR SPECIAL 10-DAY Pf,Pd•1ITS ONLY>'~* <br />EXt{IBIT ll - Reclamation Costs <br />If the surety is requested [o be less than $2500, ttie operator must submit <br />facts to support such request. Otherwise a surety of $2500 wi.11 automatically <br />be set. <br />E~}IIBIT I - Terms of Governmental Contract <br />The operator must submit a copy of the contract er othec proof that prnres the <br />necessity of a special .10-day permit. 1'lrc operator mast also suhmit evidence <br />of the surety provided under the governmental contract, if it was required. <br />