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~ <br />., <br />,_~ <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />M IIIIIIIII - - ~ <br />Notice of Intel 9I IIIIIIIII ing Operations <br />110(z) Annual I(eport RF(;EIVED <br />City of Monte vista SEP 1 1 ~gg5 <br />M-92-060 <br />Lagoon P i t* ~ Division of Minerals i~ Ge010g}~ <br />10/20/95 <br />$225.00 (Due on your Anniversary Date) <br />a. Permitted acreage: 6 acres b. County where mine is located: Rio Grande <br />Has this mine been granted TEMPORARY CESSATION STATUS? YES NO <br />Does this mine operate MORE or LESS than 180 days per year? MORE LESS ~% <br />Do you extract MORE or LESS than 70,000 tons of mineral or <br />overburden a year? MORE LESS <br />Does this mine have a phased reclamation plan? YES NO <br />Total acres affected during the report year:* o <br />Total acres reclaimed for the report year:* o <br />Total acres in various stages of reclamation:* <br />a. Backfilled: o d. Topsoil replaced: o <br />b. Graded: o Average topsoil thickness <br />c. Seeded: o replaced: o <br />List species seeded & seeding <br />rate for report year on back <br />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* None <br />Estimated total acres to be affected in the next report year:* o acres <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 Ttimetable. <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 acreage in items 2 <br />through anew ap is unnecessary. However, this must be stated above. <br />Signatur a.-r ~J/,a.1~ Date: ~6 ~~,~ ,~ ~~/ <br />Please type or print current contact name, mailing address, and phone number below: <br />COntaCt Ndme: Tony Martinez Phone <br />Company: __ City of Monte Vista <br />AddrESS: 4 Chico Camino <br />Monte Vista, CO 81144 <br />~ 719 ) AS _59 6 <br />O~y <br />~~~~ <br />Federal Tax ID No. or Social Security No.: <br />