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110 i'ermtr. Aool ication (c on t' INSTf?UCTf09S: Ttlis applfcatio.. and all accompanying matcri als must b uhmitted in duplicate. In the lntereses of efficient pro.:esslns, i.l r_a sa !ntluda the follouin infor ---_o: .. _...--. Ll ~i cc~ T--'ct ~__., ___ ,__ o.~.v g _ ~p_._.__...., 3 for guid anee; Special 10-day Permits, see RULE + for guidance.-- EXHIBIT A - Leal Description The ].e gal description must identify the affected land and be wholly adequate for field location of the property. It can be in the form of metes b bounds survey or a descrip- tion by reference to township, range, and section, to a[ leas[ the nearest quarter- quart:er section. Where applicable, the street address or lot number(s) my be used. EXHIESIT B - NSning 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. The elan should be correlated with the ^ap and should shoe where extraction will begin, and which direction, if any, it vi.ll proceed. E)41IBIT C - Nag This map should clearly define permit baundarles and indicate all roads or stackoile areas to be used is connection with the operation. All 1®ediarely adjacent landowers must be shown. The quarter section comer, section line, or any other locateable points should also be show on this map. EXRIISIT D - Wildlife, Water Resources, Vescetation and Soils Information Each of the above-mentioned subjects must be addressed as outlined in the applicable RULE. EXHIISIT E - Reclamation Plan As cr.Lth the mining plan, this should be a general discussion of the methods, equipment, phases or stages of the reclamation process and those portions of land affected by each. If possible, the plan should be closely correlated with the map. If not, the narrative ' must be comprehensive enough to draw as accurate verbal picture of the expected appear- ance of the area after completion of reclamation. EXF.I'.3IT F - Proof of Local Government Aprroval This must be a letter from the local government specifying conformance with existing zoning regulations. (IC is intended that operators may obtain local government approval conairrent with the Division's processing of the application. To do so, the operator must submit evidence which indicates that local government approval is currently pending or •ri11 at leas[ be considered within a reasonably shore time by the appropriate govern- ing body RL'i.E 1.1(10) (Consult this RL2E for full details on this requirement.) c.tHL3IT G - Source of Le?al Right to Enter This could be a copy of the lease, deed, abstract of title, or current tax receipt. . An acceptable alternative would be a statement acknowledged by a notary public that the operator has the legal right to enter and mine. EXRI3IT R - Reclamation Costs For a IIO permit, if the operator requests surety to be less than $2500, [he operatorrust subnit facts to support such a request. Otherwise, a surety of 52500 will automatically be sat. For all 111 pewits, the surety shall be $2500 per acre. EXHIBIT I - Terms of Governmental Contracts For Special 10-Day (111) Permits, the operator must submit a copy of the contract or other proof that proves the necessity of a special 10-day permit. The operator must also submit evidence of r_he surety provided under the governmental contract, if Lt vas required. NOTICE PROCEDURES After the application is considered "filed" (pursuant to RULE 1.1(10) with the Nined Land Reclamation Division, notice procedures outlined in RULES 3.2 and/or 4.2 must be followed. (FOrnat for such notices viii be included in the letter you receive from the -?tLR start informing yeu-of 'the comnlnteness (~~rr'ng'S-af-your -appi ication. ADDITIONAL IVFOR>ATION This space can be referenced for further infornatioa of any of the items on this form. To tie best of my knowledge, all the infornation presented in this application is true and =orrect. BY /~~ TI ~ C/ _ (Si c~wd fr: indi~~:.. u..l !,~_~ll~: .i~~f io r_ 1.J [D tiller [I:d CpcraCCr CJ C:115 . - ....: l.:n.)