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Y~ • - _ • <br />III'II'II'III'IIIIIOperation~~~ <br />Notice of Intent t sss E <br />110(2) Annual neN~, . 1 ~~ <br />Permittee Name: David Goss SEC 1 s <br />Permit No: M-85-140 199 <br />Anniver~aryaDate: Ol/24/92d & Gravel ~~,~a ~ned Land <br />Total: $120.00 (Due on your Anniversary Date~~DnDl~~r..• <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 LESSJ~~~///~~/°°° <br />2. Total acres affected during the report year:* St'"rtr ~ ~s ~r7c1`~y~N <br />- - 3.---Total acres .reclaimed for_ the report year:* ~C 12 ~ / <br />4. Total acres in various stages of reclamation:* ~G~9~ <br />a. Backfilled: d. Topsoil replaced: <br />b. Graded: 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, rganic material or soil <br />conditioners used for the report year:* ~o-,~,~. <br />6. Estimated total acres to be affected in the next report year:* p <br />7. COMMENTS: <br />0 <br /> <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 />F <br />Signature: Date: / ~ <br />Please type o print cu rent contact name, address, and phone number below: <br />Contact Name: ~~.U~1~ ~ osS Phone: (~~ / ) h~3 - ~~~ 5 <br />Company: GCSS .SZnd_-~~r2~V e./ <br />Address: r'- ~ <br />Call, x._ , n, ~'y~roc~ ~I ~„J <br />Federal Tax ID No. or Social Security No.: ~.,~~ <br />111 <br />