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<br />-0 4- <br />12, Primary future (Post-mining) land use (check one): <br />Cropland(CR) Pastureland(PL) <br />_ 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(FI.) <br />Rangeland(RL) - Forestry(FR) <br />Residential(RS) - Recreation(RC) <br />Developed Water Resources (WR) <br />_ General Agriculture(GA) <br />Wildlife Habitat(WI..) <br />I ndustrial./Cominerc ial(IC ) <br />Solid Waste Disposal(WD) <br />General Agriculture(GA) <br />_ Wildlife I-Iabitat(WL) <br />Industrial/Commere i al(IC) <br />- NLlining (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 11 Od 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 />Is 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 EXHIBIT" A. - Legal Description and Location Map <br />6.3.2 EXHIBIT B - Site Description <br />633 1,XIILBi,r c _ Mining Plan <br />63A l° Xl Ff31.TD - R ctarnation Plain <br />63.5) If"'XI E113t f E - ?Maps, to include thy; tocat,.on. o.# any recorded easement, <br />63. ,6 i:?mr7.113r l i,i.st o otlier Pernifis and 7.. tcenses Requirt"d <br />6.3,7 1; il_I311 41 - <_JUrcf s:t'1_egal Right-to-l ":nt Y <br />S L X11.1.131T 1-I 40unicipalitics Within a'1`wo-tuilc Radius <br />6.19 EA 1C131'1` I - Proof of Filing with County Clerk, <br />6.3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application <br />6.3. 12 EXIII.BlT L - Permanent Man-Made Struc!ures <br />I.6.2(I)(b) ADDENDUM I - Notice Requirements (sample enclosed) <br />6 <br />J Cieotcc:hnical Stability t_xhih-It. gas required) <br />.