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SAND, GRAVEL, AND MINERAL REMOVAL PERMIT APPENDIX M-I SAND, GRAVEL, AND MINERAL REMOVAL PERMIT This permit is entered into by the Douglas County Forestry Department, hereinafter referred to as the “OWNER”, and, - hereinafter referred to as the “PERMITTEE”, for the purpose of removing from the of SECTION TOWNSHIP NORTH, RANGE WEST, TOWNSHIP - DOUGLAS COUNTY, WISCONSIN, at the rate of The location of the subject site is shown on exhibit attached hereto and made a part hereof. This permit shall be in effect for commencing and expiring Being under the direction of the Douglas County Director of Forestry and Natural Resources in accordance with the following regulations set forth by the Douglas County Forest, Parks, and Recreation Committee, the PERMITTEE agrees to meet the following conditions: 1. The OWNER, or its agents, accept no responsibility for accidents of any nature whatsoever which may occur on said properties as a result of operations of said PERMITTEE. 2. Material removal operations must be carried out in a manner consistent with direction provided by the OWNER. If needed, the Director of Forestry and Natural Resources shall regulate access locations, garbage/waste disposal, culvert locations and all other such necessary items. 3. No section corners, survey monuments or survey bearing trees will be removed or destroyed by PERMITTEE. 4. Any timber removed/damaged and/or forested land removed/delayed from future timber production due to operations of permit will be paid for, by the PERMITTEE, at the going rates established by the OWNER. 5. No windrowing of forest products, brush or other materials will be allowed in pit or on adjacent lands. 6. No test holes or drilling will be allowed except by permit and such test holes or drilling will be repaired by PERMITTEE within ten days of boring. 7. No pits can be enlarged by PERMITTEE without permission of the OWNER. 8. All pits will be maintained and material removed so as to allow the maximum utilization of materials. 9. Non-mineral screenings, from crusher operations, will be removed from pit by PERMITTEE as directed by the OWNER. 10. All permits shall be for a specific period of time and/or for specified volumes of materials. 11. Reports of total yardage of gravel, sand, rock, and other materials, removed from pit will be provided in a written format to the OWNER on an annual basis by January 31st of the following year. 12. A final report of total yardage of gravel, sand, rock, and other materials, removed from pit will be provided in a written format to the OWNER upon termination of permit, 30 days following permit expiration date. 13. For permits requiring payment, final payment will be made on actual yardage at termination of permit. Partial payments, such as annual, shall be made if directed by the OWNER. 14. No equipment or litter will remain on site after termination of permit. All litter and debris left at side of operation must be hauled away to an authorized site. 15. Upon completion of permit, if determined necessary by the OWNER, the pit shall be reclaimed by PERMITTEE as directed by the OWNER. 16. Any violation of these regulations will be deemed a trespass and shall be grounds for the termination of active permits and refusal to grant future permits to persons in violation of such regulations. The penalty fine charged for a trespass shall be left to the discretion of the OWNER. 17. The PERMITTEE agrees to follow the Best Management Practices for Water Quality as directed by the OWNER. ---PAGE BREAK--- SAND, GRAVEL, AND MINERAL REMOVAL PERMIT APPENDIX M-I 18. The PERMITTEE agrees to aesthetically maintain the pit at all times throughout the duration of the permit as directed by the OWNER. 19. The PERMITTEE is responsible to acquire any necessary licenses and permits, such as those required by Douglas County Zoning Department, to conduct permitted activities and further agrees to conduct no unlawful activities on Douglas County Forest property under the guise of this permit or otherwise. 20. Additional special conditions set forth by the OWNER: a. b. c. d. etc… In witness whereof, the parties hereto have sent their hands this day of , 2007. By: Douglas County, Director of Forestry & Natural Resources Date PERMITTEE (Include Representative if Organization) Date PERMITTEE Address PERMITTEE Phone Number Witness Date