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li; <br />-4- <br />12. Primary future_(P_ost-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(PL) <br />T Rangeland(RL) _ Forestry(FR) <br />- Residential(RS) Recreation(RC) <br />Developed Water Resources (WR) <br />- General Agriculture(GA) <br />- Wildlife Habitat(WL) <br />_ Industrial/Cormnercial(IC) <br />_ Solid Waste Disposal(WD) <br />General Agriculture(GA) <br />- Wildlife Habitat(WL) <br />- Industrial/Commercial(IC) <br />- Mining (MI) <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 />.1% A _ i <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 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 - Reclamation Plan <br />6.3.5 EXHIBIT E - Maps, to include the location of any recorded easements <br />6.3.6 EXHIBIT 1{ - List of Other Permits and Licenses Required <br />6.3.7 EXHIBIT G - Source of Legal Right-to-Enter <br />6.3.8 EXHIBIT H - Municipalities Within a Two-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 EXHIBIT L - Permanent Man-Made Structures <br />1.6.2(1)(b) ADDENDUM I - Notice Requirements (sample enclosed) <br />6.5 Geotechnical Stability Exhibit (as required)