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110 Permit Appl,cation (cont'd.)
<br /> 14. Present land use (i.e. , agrl- 10 ,7 ,r'i�% / i/.:'w,/
<br /> cultural, industrial, etc.)
<br /> IS. Proposed future land use I)PF /7G1//I/F (" D%'
<br /> (Goal of reclamation)
<br /> INFORIVED Ll. P SO L>> in.IrY
<br /> INSTRUCTIONS: This application,and all accompanying materials must be submitted in duplicate.
<br /> In the Interests of efficient processing, please Include the following Informa-
<br /> tion S Items. Limited Impact Operations, see RULE J for guidance; Special I0-
<br /> day Permits, see RULE 4 for guidance.
<br /> .------—--------------------------'--------_____--------___
<br /> EXHIBIT 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 form of metes s bounds survey
<br /> or a description by reference to township, range, and section, to at least the .
<br /> nearest quarter-quarter section. Where applicable, the street address or lot
<br /> number(s) may be used.
<br /> EXHIBIT B - Mining Plan
<br /> This can be a general discussion of the methods, equipment, phases or stages of the
<br /> operation and those portions of land affected by each. The plan should be
<br /> correlated with the map and should show where extraction will begin, and which
<br /> direction, If any, it will proceed.
<br /> EXHIBIT C - Map This map should clearly define permit boundaries and indicate all toads or stockpile
<br /> areas to be used in connection with the operation. All immediately adjacent landowners
<br /> oust be shown. The quarter sectlon corner, section line, or-any other locateable points
<br /> should also be shown on this map.
<br /> EXHIBIT D - Wildlife, Water Resources, Vegetation and Soils Information
<br /> Each of the above-mentioned subjects must be addressed as outlined In the applicable
<br /> RULE.
<br /> EXHIBIT E - Reclamation Plan
<br /> As with the mining plan, this snouid be a general discussion of the methods, equipment,
<br /> phases or stages of the reclamation process and those portions of land affected by each.
<br /> If possible, the plan should be closely correlated with the map. If not, the narrative
<br /> oust be comprehensive enough to draw an accurate verbal picture of the expected appear-
<br /> ance of the area after completion of reclamation.
<br /> EXHIBIT F - Proof of Local Government Approval
<br /> ,This must be a letter from the local government specifying conformance with existing
<br /> zoning regutatiu,,;. ;; I,-,tanded that operator- ,_y ="t=in local government approval
<br /> concurrent with the Division's processing of the application. To do so, the operator
<br /> Bust submit evidt.,,m -;.;ch Indicates that local govt. approval Is currently pending
<br /> or will at least be considered within a reasonably short time by the appropriate
<br /> gc%-Grnin� `sdy. 1.1(lo) .(consult this RULE for full details on this requirement.)
<br /> MI'217 - coo--- ^s '•gal Right t, F.,rnr
<br /> This c=1_4 be a copy of the lease, deed, abstract of title, or current tax receipt.
<br /> An acceptable alternative would be a statement acknowledged by a notary public that
<br /> the oFc.-"or has the legal right to enter and mine. _
<br /> EXYJ.B!_T u - Reclamation Costs _
<br /> If the surety Is requested to be less than $2500, the operator must submit facts to /V�H
<br /> support such a request. Otherwise, a surety of $2500 will automa tically be set.
<br /> •*+ FOR SPECIAL 10-DAY (I11) PERMITS ONLY +**
<br /> EXH181T I - Terms of Governmental Contract
<br /> For Special 10-Day (Ill) Permits, the operator must submit a copy of the contract or
<br /> other proof that proves the necessity of a special 10-day permit. The operator must
<br /> also submit evidence of the surety provided under the governmental contract, If It was
<br /> required.
<br /> NOTICE PROCEDURES
<br /> After the application is considered "filed" (pursuant to RULE 1.1 (10) wl th the Mined Land
<br /> Reclamation Division, notice procedures outlined in RULES 3.2 G/or 4.2 must be followed.
<br /> (Format for such notices wl II be included in the letter you receive from the MLR staff
<br /> Informing you of the completeness ("filing") of your application.
<br /> ADDITIONAL INFORMATION
<br /> This space can be referenced for further Information of any of the Items on this form.
<br /> TNF /Ti/ IJ F 2/7-kS lif///_ /_ /74//V
<br /> /N I �,4R,c %/NIF,50
<br /> To the best of my knowledge, all the Information presented in this application Is true
<br /> and correct. f.��J // 4
<br /> �RyL� GYGt4."raj,/ BY
<br /> r
<br /> TITLE
<br /> R Diu' Si ad by divid leg y suthor-
<br /> I ad to nd th pe rat to this
<br /> application.)
<br />
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