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<br />Notice of Intent to Continue Mining Operations <br />112 Annual Report <br />Permittee Name: Penn Mountain Mining Inc <br />Permit No: M-85-022 <br />Operation Name: Bullger Basin Placer <br />Anniversary Date: 05/23/95 <br />Total: $550.00 (Due on your Anniversary Date) <br />1. <br />2. <br />3 <br />4 <br />5 <br />6 <br />7. <br />8. <br />a. Permitted acreage: b. County where mine le looted: _ <br />Hae this mine been granted TEMPORARY CESSATION STATUS? ~ YES <br />Does this mine operate MORE or LESS than 180 days per year? MORE <br />Dose this mine have a phased reclamation plan? YES <br />Total acres affected during the report year:+ <br />Total acres reclaimed for the report year:* <br />Total acres in various stages of reclamation:* <br />a. Backfilled: d. Topsoil replaced:, <br />b. Graded: Average topsoil t~:icknese <br />c. Seeded: replaced: ~ <br />List species seeded & seeding <br />rate for report year on back <br />The type and approximate quantity of fertilizers, organic mat~rial or soil <br />conditioners used for the report year:* ~ <br />Estimated total acres to be affected in the next report year:i <br />9. COMMENTS: <br />* Please show the location of the acreage for items 4 - 6 on yo r map**. <br />Indicate the phases of the reclamation which have been completed, cor elated with <br />your timetable. II <br />** NOTE: If there have not been any changes since the last annual report and you <br />previously submitted a map which correctly depicts the current acreag in items 2 <br />through 6, then a new map ie unnecessary. However, you must state th~ie fact above. <br />Signature: Date: <br />Please type or print current contact name, mailing address, and phonenumber below: <br />Contact Name: <br />Company: <br />Address: <br />Phone: <br />Fax: <br />NO <br />LESS <br />NO <br />Federal Tax ID No. or Social Security No.: <br />