PERMFILE125860

• Permit No: M1978011
• IBM Index Class Name: Permit File
• Doc Name: LIMITED IMPACT & SPECIAL 10-DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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14. Present land use Pasture land.
(i.e., agricultural, industrial, etc.)
15. Proposed future land use Pasture land.
(Goal of recla~atioa)
I275TRUCTIO~S: This application forts must be submitted in duplicate and each farm must
be accompanied by the following infor...atioa and itecLS. The application
will not be processed until complete. See RULE 3 (for Limited Impact)
or RULE 4 (for Special 10-day) for additional guidance.
ER3IBIT A - Legal Description
The legal description must identify, the affected land and be wholly adequate for
field location of the property. It can bs ir. the form of mates and bounds survey
or a description by reference to township, range, and section to at least the
nearest quarter quarter section. Where applicable, the street address or lot
number(s) may be used.
E}~T32T B - Mining 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. Tha plan should be
closely correlated with the map an3 should show where e:ctraction will begin, which
direction iC w111 proceed_
E:{3I3IT C - Man
This map should be as comprehensive as possible is terns of clearly defining
the pe~3it boundaries and indicating all roads or stockpile areas to be used in
coarectioa with the operation. All itrmediately adjacent laado•.rners must be shown.
The closest quarter section cozaer, section line, or any other locateable point
should also be saowa on the map.
EYH-BIT D - !71Id1ife, Linter Resources, Vegetation and Soils Information
Each of the above-mentioned subjects must be addressed as outlined in the
applicable Rule, under item number ten (10).
E3HIBIT E - Reclamation Plan
As with the mixing plan, this should be a general discussion of the methods,
equipment, phases or stages of the reclamation process and those portions of
laced affected by each. If possible, the plan should be closely correlated
with the map. If not, the narrative must be comprehensive enou3h to draw an
accurate vezbal picture of the e:cpected physical appearance of the area after
completion of reclamation.
E4FiI3IT F -Proof of Local Government Approval
This must be a letter frog the local govenaent specifying conformance with
existing zoning regulations.
E'G~iIBIT G - Source of Legal Rikht to Enter
ibis could be a copy of the lease, deed, abstract of title, or current tax
receipt. Ice lieu thereof, a statement acknowledged by a notary public that
the operator has the legal right to enter and mine w-L11 be accepted.
**FOR SPECIAI. 10-DAY PERMITS O:ILY~*
E~IBIT H - Reclamation Costs
If the surety is requested to be less than $2500, the operator must submit
facts to support such request. Otherwise a surety of $2500 will automatically
' 6e set.
~II23IT T - Ter^_s of Goveranental Contract
The ooeratoz must submit a copy of the contract or other proof that proves the
necessity of a special 20-day permit.. the operator must also submit evidence
of the surety provided under the governmental contract, if it was required.
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