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-4- <br />12. Preoarv furore (Peat-mieins!l land uae (check one): <br />_ Croplerd(CR) <br />_. Rangeland(RL) <br />_ Rcsrdeniial(RS~ <br />_ Developed WaterResotaces(WR) <br />13. Primary oreeeM land aao (check one): <br />_ Cropland(CR) <br />_ Rangeland(RL) <br />_ Residcntiel(RS) <br />_ Developed Water Resotm;es (WR) <br />~/ Pesttaeland(PL) _ General Agricvlture(GA) <br />_ Foreshy(FR) _ WildlifeHabirat(WL) <br />_ Rareation(RC) _ hdustrial/Carwercial(IC) <br />_ Solid WasteDispaaal(WD) <br />/ Pastwelarxl(PL) _ General Agticulhae(Ga) <br />_ Forestry~(FR) _ WildlifeHabitat(WL) <br />_„ Recreation(RC) _ ItulttstriallCotrtmetcial(1C) <br />_ Mining (h'II`I) <br />14. Jf this operation will use designated chemicals, or will result, or prescruJy has acid mintdrainage - you wnral use this application <br />form. You must submit either a I 1 t1d or 1 I2d application Corm for LlraigWed Mining Optxations. In either tax, you must li9t any <br />acidic or imcic-forming memriels, e~osed or disturbed as a restilt ofthe mining operetion, and whethc the operation will restrlt inor <br />presently has acid mine drainage: <br />Not applicable <br />I5. DescrintiondAmendmentorCoevenfoa: <br />If }rou arc emending or cortverting an existing operation. provide a brief narrative describing the proposed change(s): <br />Moos & Exhibits: <br />Submit two (2} complete, unbound copies of the following application exhibits: <br />6.3.1 EXHIBIT A • Legal Description and location Map <br />6.3.2 EXHIBIT B -Site Description <br />6.3.3 EXHIBIT C -Mining Plan <br />6.3.4 EXHIBIT D - Redamalian Plan <br />6.3.5 EXHIBIT E -Maps, to include the location of arty recorded easemems <br />6.3.6 EXHIBIT F - List of Other Ptrrttits and Licenses Required <br />6.3.7 EXHIBIT G - Source oC Legal Right-to-Enter <br />6.3.8 EXHIBIT H -Municipalities Within a Two-mile Radius <br />6.3.9 EXHIBIT 1- Proof of Filing with County Clerk <br />6.3.10 EXHIBIT I - Proof of Mailing Notitxs of Permit Application <br />6.3.12 EXHIBIT L -Permanent Man-Made Shuctures <br />1.6.2(lxb) ADDENDUM 1 -Notice Requirements {sample enclosed) <br />6.5 Geotedmical Stability Exhibit (as required) <br />