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12. Prima future Post -minin land use chec Cropland(CR) Rangeland(RL) Residential(RS) Fl Developed Water Resources(WR) 13. Prim land use (check one): I Cropland(CR) Rangeland(RL) Residential(RS) Developed Water Resources (WR) 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: N/A 15. Description of Amendment or Conversion: - 4 - If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s): All other exhibits remain the same. Only the location has changed Maps & Exhibits: Pastureland(PL) Forestry(FR) Recreation(RC) Pastureland(PL) Forestry(FR) Recreation(RC) 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(1)(b) 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) I General Agriculture(GA) Wildlife Habitat(WL) Industrial /Commercial(IC) Solid Waste Disposal(WD) El General Agriculture(GA) Wildlife Habitat(WL) E Industrial /Commercial(IC) Mining (MN)