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<br />• • r-~ ~ iii iiiiiiiiiiiu iii <br />999 <br />Notice of Intent to Continue,Mining Operations ~~ ~ ~ ~ ~ <br />112 Annual Report ,,;, ~ <br />,, ~~~~ <br />Permittee Name: Farmers Bank of Brush <br />Permit No: M-80-135 ~°''~~~~yLand <br />Operation Name: Headley Farms `~e0'a'~'a!irr Di~~isir~n <br />Anniversary Date: 10/07/91 <br />Total: $430.00 (Due on your Anniversary Date) <br />1. Has your mine been granted TEMPORARY CESSATION STATUS? <br />Does your mine operate MORE or LESS than 180 days per year? <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. <br />b. Graded: -o- <br />c. Seeded: -0- <br />List species seeded & seeding <br />rate for report year on back <br />5 <br />YES NO <br />MORE LESS <br />1/2 acre <br />-0- <br />Topsoil replaced: -0. <br />Average topsoil thickness <br />replaced: -0- <br />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:` none used <br />6. Estimated total acres to be affected in the next report year:` ? <br />7. COMMENTS: There have been no changes since the last report. Please refer <br />to the map submitted at'that time <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 />~- e <br />Signature: ~ Date: ~i; .C.sZ~~~/ 9 9~ <br />o nan R Tisdale, Presi ent / <br />Please type or print current contact name, address, and phone number below: <br />Contact Name: Norman R Tisdale phone: (303 ) 842-5101 <br />Company: The Farniers State Bank of Brush <br />Address: 200 Clayton St., P 0 Box 324 /// n„ , <br />Brush CO 80723-0324 AC'1~YA./ ~~ <br />I 7~I~ <br />Federal Tax ID No. or Social Security No.: <br />