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<br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />~~~ ~~~~~~~~~~~~~~~~ der v`G~a ~.`. <br />Notice of Intent t~ sss 7perations <br />110(2) Annual Report JAN o iqq+ <br />Richard D. Mott <br />M-80-049 <br />Mott Gravel Pit <br />02/18/91 <br />Mined L2 ~d <br />Reclamation Div;aion <br />Z <br />E50.00 (Due on your Anniversary Date) <br />1. Has your mine been granted TEMPORARY CESSATION STATUS? YES NO <br />Does your mine operate MORE or LESS than 180 days per year? MORE LESS <br />2. Total acres affected during the report year:* _~ <br />3, Total acres reclaimed for the report year:* <br />4:" Total acres in various stages of reclamation:* <br />a. Backfilled: _ ~ ~-~:,,0 d. Topsoil replaced: <br />b. Graded: 1~___~fr~` Average topsoil thickness <br />c. Seeded: replaced: <br />List species seeded & seeding <br />rate for report year on back <br />5. The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* <br />6. Estimated total acres to be affected in the next report year:* <br />7. COMMENTS: <br />* Please show the location of the acreage for items 2 - 6 on your map**. <br />Indicate the phases of the reclamation which have been completed, correlated <br />with your timetable. <br />NOTE: If there have not been any changes since the last annual report and <br />you previously submitted a map which correctly depicts the current acreage in <br />items 2 through 6, then a new map is unnecessary. However, you must state this <br />fact above. <br />Signature: Date: / ~L9 / <br />Please type or print current contact name, address, an phone number below: <br />Contact Name: Y~ l ~~ r4 v~c( ~ Ma~ Phone: (303) 9a / - 733 / <br />Address: ,~~_S'yo C%aY- /-_~.~/~ _ ~LC~ <br />8/~~ / ]' <br />ova( <br />~~ <br />