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_4_ <br />12. Pri_marv future (Post-mininsr) land use (check one1: <br />Cropland(CR) ,~ pastureland(PI,} ,___ General Agriculture(GA) <br />~Rangeland(RL) ,,_ Farestry(FR) ~ Wildlife Habitat(WL) <br />Recreation(RC) <br />_T Residential(RS} _._ IndustriaUCotrnttercial(IC) <br />- <br />i Developed Water Resources(WR) ____ Solid Waste Disposal(WIa) <br />i 3. Prirnarv present land use tcheck one1: <br />~ropland(CR) ~,_„ Pastureland(PL) ~ General Agriculture(GA) <br />_,~ Rangeland(RL) ,~ Forestry(FR) Wildlife Iiabitat(WL) <br />Recreation(RC) IndustriaUConunercial(IC) <br />- Residential(RS} - - <br />_Developed Water Resources (WR) - Mmuig (MN) <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 1 lOd 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 mirte drainage: /n~ <br />//T ____ <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 />Maus & Exhibits: <br />Submit two (2) complete, unbound copies of the following application exhibits: <br />63.1 EXHIBIT A -Legal Description and Location Map <br />6,3,2 EXHIBIT B -Site Description <br />63,3 EXHIBIT C -Mining Plan <br />6.3.4 EXHIBIT D -Reclamation Plan <br />6,3,5 EXHIBIT E -Maps, to include the location of any recorded easements <br />63.6 EXHIBIT F - List of Other Permits and Licenses Required <br />63.? EXHIBIT G -Source of Legal Right-to-Enter <br />63.8 EXHIBIT H -Municipalities Within aTwo-mile Radius <br />6.3.9 EXHIBIT I -Proof of Filing with County Clerk <br />6.3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application <br />6.3.12 EXI~IIBIT L -Permanent Man-Made Structures <br />1.6.2(1)(b) ADDENDUM 1 -Notice Requirements (sample enclosed} <br />6.5 Geotechnical Stability Exhibit (as required} <br />