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<br />-4- <br />12. Primaryfuture (Post-minim-) land use (check one): <br />Cropland(CR) Pastureland(PL) <br />X Rangeland(RL) Forestry(FR) <br />Residential(RS) Recreation(RC) <br />_ Developed Water Resources(WR) <br />13. Primary present land use (check one): <br />_ Cropland(CR) - Pastureland(PL) <br />-y- Rangeland(RL) ___- Forestry(FR) <br />- Residential(RS) _ Recreation(RC) <br />_ Developed Water Resources (WR) <br />_ General Agriculture(GA) <br />Wildlife Ifabitat(WL) <br />" Industrial/Commercial(IC) <br />Solid Waste Disposal(WD) <br />General Agriculture(GA) <br />Wildlife Habitat(WL) <br />_ Industrial/Commercial(IC) <br />Mining (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 110d 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 />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 />Maps & Exhibits: <br />Submit two (2) complete, unbound copies of the following application exhibits: <br />6.3.1 <br />6.3.2 <br />6.3.3 <br />6.3A <br />63.5 <br />6.3.6 <br />63.7 <br />6.3.8 <br />6.3.3 <br />6.3.10 <br />6.3.12 <br />l.6.2(1)(b) <br />6.5 <br />EXHIBIT A - Legal Description and Location Map <br />EXHIBIT B - Site Description <br />EXHIBIT C - Mining Plan <br />EX1,41BIT D - Reclamation Plan <br />EXI:IIBIT E -.Maps, to include the location of any recorded. easements <br />EXHIBIT' F - List of Other Permits and Licenses Required <br />1'S:X14IBIT G - Source of txgal Right-to-Enter <br />EXHIBITH - Municipalities Within. a Two-mile Radius <br />EX.IiL131'T I - Proof of Filing with County Clerk. <br />EXHIBIT J - Proof of Mailing Notices of Permit Application <br />EXHIBIT I., - Permanent Man-Made Structures <br />ADDI NDUM 1 - Notice Requirements (sample enclosed) <br />Geotechnical Stability Exhibit (as required)