2013-08-16_PERMIT FILE - M2013054

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-4- 12. Prim kry future ost minin land use chec 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) 13. PrimgcWresent land use (check one): Cropland(CR) D Pastureland(PL) ❑ General Agriculture(GA) Rangeland(RL) ® Forestry(FR) ® Wildlife Habitat(WL) Residential(RS) Recreation(RC) Industrial/Commercial(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: 15. Description of Amendment or Conversion: If you are amending or converting Maps & Exhibits: provide a brief narrative describing the proposed change(s): Submit two (2) complete, unbound copies of the following application exhibits: 6.3.1 EXHIBIT A - Legal Description and Location Map 6.3.2 EXHIBIT B - Site Description 6.3.3 EXHIBIT C - Mining Plan 6.3.4 EXHIBIT D - Reclamation Plan 6.3.5 EXHIBIT E - Maps, to include the location of any recorded easements 6.3.6 EXHIBIT F - List of Other Permits and Licenses Required 6.3.7 EXHIBIT G - Source of Legal Right -to -Enter 6.3.8 EXHIBIT H - Municipalities Within a Two -mile Radius 6.3.9 EXHIBIT I - Proof of Filing with County Clerk 6.3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application 6.3.12 EXHIBIT L - Permanent Man-Made Structures 1.6.2(1)(b) ADDENDUM 1- Notice Requirements (sample enclosed) 6.5 Geotechnical Stability Exhibit (as required)