2010-12-21_PERMIT FILE - M2010083

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-4- 12. 13 Cropland(CR) Pastureland(PL) General Agriculture(GA) Rangeland(RL) Forestry(FR) Wildlife Habitat(WL) Residential(RS) - Recreation(RC) Industrial/Commercial(IC) Developed Water Resources(WR) Solid Waste Disposal(WD) resent rang use rcnrch uuc,. F? GA lt l A i Cropland(CR) Pastureland(PL) M ) ure( cu gr Genera Rangel.and(RL) Forestry(FR) Wildlife Habitat(WL) Residential(RS) M Recreation(RC) 6 Industrial/Conmiercial(IC) Developed Water Resources (WR) Mining (MN) 14. If this operation will use designated chemicals, or will result, or presently has acid mine drainage -you cannot use this application form. You must submit either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: Not Applicable 15. Description of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): Not Applicable Maps & Exhibits: Submit two (2) complete, unbound copies of the following application exhibits: 6.3.1 6.3.2 6.3.3 6.3.4 6.3.5 6.3.6 6.3.7 6.3.8 6.3.9 6.3.10 6.3.12 1.6.2(lxb) 6.5 EXHIBIT A - Legal Description and Location Map EXHIBIT B - Site Description EXHIBIT C - Mining Plan EXHIBIT D - Reclamation Plan EXHIBIT E - Maps, to include the location of any recorded easements EXHIBIT F - List of Other Permits and Licenses Required EXHIBIT G - Source of Legal Right-to-Enter EXHIBIT H - Municipalities Within a Two-mile Radius EXHIBIT I - Proof of Filing with County Clerk EXHIBIT J - Proof of Mailing Notices of Permit Application EXHIBIT L - Permanent Man-Made Structures ADDENDUM 1 - Notice Requirements (sample enclosed) Geotechnical Stability Exhibit (as required)