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<br />. ~. <br />OR <br />14. Preaant load use ,,/ ~ <br />~. 7~i.Ek E Ngs6E6 %n <br />(i.e., agricultural, industrial, etc.) ,, _. ~. ,,. A__, „-~ _ - __.- -' <br />15. Proposed future Iaad use ~ ~ ,~E C.L~E h~TiCi/ <br />(Coal of reclamation) <br />INSTRUCTIONS: This application form must be submitted in duplicate and each form must <br />be accompanied by the following information and items. The application <br />will not be processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional guidance. <br />E7D3IBIT A - Legal Description <br />The legal description must identify the affected land and be wholly adequate for <br />field location of the property. It can be in the fora of metes and bounds survey <br />or a description by reference to township, range, and section to at !east the <br />nearest quarter quarter section. Where applicable, the street address or lot <br />number(s) may be used. <br />EXHIBIT B - ;fining Plan <br />This can be a general discussion of the methods, equipment, phases or stages of <br />the operation and those portions of land affected by each. The play. should be <br />closely correlated with the map and should shoe where extraction will beg_a, which <br />direction it will proceed. <br />EXSIBIT C - :Sap <br />This map should be as comprehensive as possible is terns of clearly defi:._zg <br />the permit boundaries and indicating all roads or stockpile areas to be used _: <br />connection •aith the operation. All immediately adjacent landowners must Se shorn. <br />The closest quarter section corner, section Liae, or any other locateable ?oiat <br />should also be shown on the map. <br />E~iIBLT D - Wildlife, Water Resources, Vegetation and Soils Information <br />Each of the above-mentioned subjects must be addressed as outlined is t4c <br />applicable Rule, under item number tea (10). <br />EXHIBIT E - Reclamation Plan <br />As with the mining plan, this should be a general discussion of the aethods, <br />equipment, phases or stages of the reclamation process sad those portions of <br />load 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 as <br />accurate verbal picture of the expected physical appearance of the area after <br />completion of reclamation. <br />ESSIBIT F - Proof of Local Government Approval <br />This mw i be a letter from the local government specifying conformance with <br />!=eating zoning regulations. <br />ESHIBZT ~- Source of Legal Right to Enter <br />-T <br />This could be a copy of the lease, deed, abstract of title, or current tax <br />receipt. In lieu thereof, a statement acknowledged by a notary public that <br />the operator has the legal right to enter and mine will be accepted. <br />**FOR SPECIAL 10-DAY PERMITS OILY** <br />EffiIBIT ~ - Reclamation Costs <br />'7-' <br />If the surety 1, requested to be less than $2500, the operator must submit <br />facts to support such request. Otherwise a surety of $2500 will automatically <br />be net. <br />~IBIT~~ Terms of Governmental Contract <br />The operator moat submit a copy of the contract or ocher proof that proves the <br />aacesaity of a spacial 10-day permit. The operator must also submit evidence <br />of the surety provided under the governmental contract, if it wan required. <br />