Date of Application ___________________________________
Company Name___________________________________________________
Federal Employer ID_____________________ State ID___________________
Contact Person ____________________________________________________
Address__________________________________________________________
Phone _______________________ Fax___________________Cell________________
Email_____________________________________________________________
Proof of Insurance (Please attach)
Legal Description of land for proposed mine development _________________________
______________________________________________________________________________________
Tax parcel number____________________________________________________
Name and address of surface land owner ____________________________________
______________________________________________________________________
Name and address of mineral owner _________________________________________
_______________________________________________________________________
Describe current land uses within and adjacent to the project area ___________________
________________________________________________________________________
List other permits (county, state etc.) necessary for this project, indicate status and provide a copy. _______________________________________________________
_____________________________________________________________________
Specify total area (in acres) to be affected by this project. Include areas for future expansion, stockpiling, processing, haul roads, settling basins, buildings, parking facilities. _________________
Describe the method that will be used to dispose of brush and other vegetative debris.
_______________________________________________________________________
Describe the methods that will be used to retain topsoil___________________________
_______________________________________________________________________
Describe material to be mined_______________________________________________
Which town and county roads will be used to transport material?____________________
________________________________________________________________________
Describe the methods used to control dust on haul roads __________________________
________________________________________________________________________
Ultimate destination of material ______________________________________________
How many loads per day?_________________________ Weight per load__________
Length of time mine is to operate _______________20__ to ________________20__
Hours of operation each day________________________
Identify the number of employees expected to work at the site and the facilities that will be provided ____________________________________________________________
______________________________________________________________________
Describe the processing methods that will be used at the site. ______________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Describe the volume of water needed at the site and the source of the water.___________
________________________________________________________________________
List chemical substances that will be used at the site and how they will be stored at the site. ____________________________________________________________________
________________________________________________________________________
Number and type of structures to be erected on site______________________________
_______________________________________________________________________
________________________________________________________________________
Indicate the observed or estimated (circle one) groundwater elevation in the project area and reference depth to a permanent benchmark _____________feet
List resources that may be impacted by this project, identify impacts, and describe measures that will be taken to mitigate those impacts _____________________________
________________________________________________________________________
Describe measures that will be taken to screen the operation from view of surrounding land uses or an explanation of why such measures are not needed. _________________
_______________________________________________________________________
Describe erosion control practices that will be used during mining. If no measures will be used, explain why none are needed.___________________________________________
________________________________________________________________________
Has a study been conducted to identify endangered species on the land? ______________
Has an environmental impact statement been prepared? ___________ (Please attach)
Describe progressive reclamation activities that will occur over the life of the operation.
________________________________________________________________________
________________________________________________________________________
Describe the methods that will be used at the cessation of seasonal operations to stabilize slopes from erosion. _______________________________________________________
________________________________________________________________________
Describe the interim reclamation methods that will be used if the site will become inactive at the close of current operations for an unspecified period of time ___________
________________________________________________________________________
________________________________________________________________________
Describe proposed reclamation including final slopes, high wall reduction, benching, terracing, and other structural slope stabilization measures. ________________________
________________________________________________________________________
________________________________________________________________________
Describe anticipated topography, water impoundments, artificial lakes, and future land use of the site. __________________________________________________________
_______________________________________________________________________
Describe plans for the disposition of surface structures, roads, and related facilities after completion of mining. _____________________________________________________
________________________________________________________________________
Describe the methods proposed for the disposal or reclamation of oversize and undersized materials. _______________________________________________________________
________________________________________________________________________
Describe or attach a copy of a seeding plan that includes methods of seed bed preparation, seed mixtures, seeding rates, mulching, and other techniques needed to accomplish site stabilization. ________________________________________________________________________
________________________________________________________________________
Describe long term maintenance needed to support reclamation. ____________________
________________________________________________________________________
Provide an estimate of the reclamation cost of each phase of the project or the entire site if phasing is not planned.
________________________________________________________________________
________________________________________________________________________
To the best of my knowledge, I certify that the information provided on this application and accompanying documents is true and accurate.
Property Owners signature__________________________________Date____________
Signature of this application authorizes the Town of Howard staff and its designees to enter upon the property to perform needed inspections. Entry may be without prior notice.
Mineral Owners signature___________________________________Date____________
Company________________________________________________________________
Signature of this application authorizes the Town of Howard staff and its designees to enter upon the property to perform needed inspections. Entry may be without prior notice.
Return Home
Legal Notices Home Privacy Notice
The file was last modified :