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-4- <br />12. Prinnarv future (Post-mining) land use (check ones: <br />Cropland{CR) _ Pastureland(PL) <br />.Rangeland(RL) _ Forestry(FR) <br />_v Residential(RS) ____ Recreation(RC) <br />~, Developed Water Resources(WR) <br />13. Prtnnar~ present land use (check one): <br />_,_.., Cropland(CR) ^ Pastureland(PL) <br />____ Rangeland(RL) .~ Foresiry(FR} <br />_____ Residential(RS) u..,_ Recreation(RC) <br />,~ Developed Water Resources (WR} <br />.__ General Agriculture(GA) <br />_, Wildlife Habitat(WL) <br />Industrial/Commercial(IC) <br />_~ Solid Waste Disposal(Wll} <br />_ General Agriculture(GA} <br />Wildlife Habitat(WL) <br />Industrial/Commercial(IC) <br />Mining (Mlv} <br />14. If this operation will use designated chemicals, or will result, or presently has acid mine drainage -you cannot use this application <br />form. You must submit either a 11(ki or 112d application form for Designated Mining Operations. In either case, you must list <br />any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will <br />result in or presently has acid mine drainage: <br />Not applicable <br />15. Description of Amendment or Conversion: <br />If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): <br />Mans & Exhibits: <br />Submit twa (2} complete, unbound copies of the following application exhibits: <br />6.3. l EXHIBIT A -Legal Iescription and Location Map <br />6.3.2 EXHIBIT B -Site Description <br />6.3.3 EXI~I:I:BIT C -1vlining Plan <br />6.3.4 EXHIBIT D -Reclamation flan <br />6.3.5 E~I-IIBIT' E -Maps, to include the location of any recorded easements <br />6.3.fi EXFIIBIT F -List of Other Permits and l:,icenses Required <br />6.3.? EXI-iIBFI' Ci -Source of Legal Right-to-Enter <br />6.3.8 EXHIBIT H _ Municipalities Within a Twcrmile Radius <br />6.3.9 EXHIBIT 1- Proof of I;iling with Coanty Clerk <br />6.3.10 EXHII3TT J - Proof of Mailing Notices of Permit Application <br />6.3.12 EXI~IBI"I' I. -Permanent Man-Made Structures <br />I.6.2(1)(b) ADDENDUM 1 -Notice Requirements (sample enclosed} <br />6.5 Geotechnieal Stability Exhibit (as required} <br />