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.. ~ TYPE OR PRINT CLEARLY <br />14. Present land use GRAZING FOR LIVESTOCK <br />(i.e,, agricultural, industrial, etc.) <br />15. Proposed future land use A '0 LIVESTOCK <br />(Coal of reclamation) <br />INSTRUCTIONS: This application form must be submitted in duplicate and each fora 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 />FXkiIBIT 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 forest 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. Where applicable, the street address or lot <br />number(s) may be used. <br />EXfiIBIT B - Mining 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 plan should be <br />closely correlated with the map and should show where extraction will begin, which <br />direction it will proceed. <br />E.CHIBIT 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 stoc3cpile areas to be used in <br />connection with the operation. All immediately adjacent landowners must be shown, <br />The closest quarter section comer, section line, or any other locateable point <br />should also be shown on the map. <br />ERHIHIT A - Wildlife, Water Resources, Vegetation and Soils Information <br />Each of the above-mentioned subjects must be addressed as outlined in the <br />applicable Rule, under item ntmtber ten (10). <br />EYfiIBIT E - Reclamation 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 expected physical appearance of the area after <br />completion of reclamation. <br />EYYHIBIT F - Proof of Local Government Approval <br />This must be a letter from the local government specifying conformance with <br />existing zoning regulations. <br />EXfiIBIT G - Source of Leal Right to Enter <br />This could be a copy of the lease, deed, abstract of title, or current tan <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 S?EC7AT. 1D-DAY P°&YiTS ONLY** <br />ERHIBIT H - Reclamation Costs <br />If the surety is requested to be less than $25D0, the operator must submit <br />facts to support such request. Otherwise a surety of $2500 wiJ.l automatically <br />be set. <br />E~tiIBIT I - Terms of Governmental Contract <br />The operator moat submit a copy of the contract or other proof that proves the <br />necessity of a especial 10-day permit. The operator must also submit evidence <br />of the surety provided under the governmental contract, if it was required. <br />