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_., <br />~~ ~ ~ III IIIIIIIIIIIIIIII ~ ~~_~~ - <br />~, <br />Notice of I...,,... .,,999 .,",,,.~ Mining Operations <br />110(2) Annual Report ~CC29 1993 <br />Permittee Name: David Goss ~''~'~=..^.2~- , <br />Permi t No : M-85-140 ° ~ ~.,;~~~ <br />Operation <br />Anniversa Name: <br />ry Date: Goss Sand & Gravel* <br />01/24/94 ~ ~ 3~ <br />Total: $225.00 (Due on your Anniversary Date) n ~j <br />O <br />1. Has this mine been granted TEMPORARY CESSATION STATUS? NO <br />YES <br />Does this mine operate MORE or LESS than 180 days per year? MORE LESS <br />2a. Financial Warranty: $ ~~DOr ~ 2b. Permitted acreage <br />3. Does this mine have a phased reclamation plan? <br />4. Total acres affected during the report year:* <br />5. Total acres reclaimed for the report year:* <br />Q~ a <br />t <br />YES NO <br />--, ' - <br />-~ - <br />6. Total acres in various stages of reclamation:* <br />a. Backfilled: ~ ~ "' d. Topsoil replaced: - rJ - <br />b. Graded: - ~ - Average topsoil thickness <br />c. Seeded: - 0 - replaced: - ~ - <br />List species seeded & seeding <br />rate for report year on back <br />7 <br />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* - /L~ - <br />8. Estimated total acres to be affected in the next report year:* ~ ,C C ?'~ S <br />9. COMMENTS: <br />Please show the location of the acreage for items 4 - 6 on your map*`. <br />Indicate the phases of the reclamation which have been completed, correlated with <br />your timetable. <br />** NOIE: If there have not been any changes since the last annual report and you <br />previously submitted a map which correctly depicts the current acreage in items 2 <br />through 6, then ~rjew map is unryeyessary. However, this must be stated above. <br />Signature: <br />Please type or <br />Contact Name <br />Company: <br />Address: <br />^ -/~-~-~~ Date : ~ ~-- ~Z. y - ~ ~ <br />int current contact name, mailin ddress, and phone number below: / <br />~~ur~. (ioSSf~ (n~ Phone: (~! )!'0~~-o2~J~`1 <br />l~ n ~ S C(3... oL ~' ~+ h~17 C <br />~ `= ~ <br />Federal Tax ID No. or Social Security No.: <br />1'~ <br />\\ <br />