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ermittee Name: <br />Permit No. . <br />Operation Name: <br />Anniversary Date: <br />Total: <br />1. a. Permitted acreage: ~~'~ b. County where mine is located: !(~ ~ /i(Q/~ <br />2. Has this mine been granted TEMPORARY CESSATION STATUS? <br />~ III IIIIIIIIIIIII III ~ <br />999 '~FC~I~iF_C <br />Notice of Intent to Continue Mining Operations <br />112c Construction Materials Annual Report 'lA~ n O <br />ri :l V 99~ <br />Mathias Concrete Inc <br />M-77-140 <br />N Farm Rd Pit No 1* JiPisi00 Oi ;„u,,;,aiy a .~~wu91 <br />January 15, 1997 <br />$550.00 (Due on your Anniversary Date) <br /> <br />Does this mine operate MORE or LESS than 180 days per year? <br />3. Does this mine have a phased reclamation plan? }( <br />l.~K . <br />4. Total acres affected during the report year:* <br />G[ <br />5. Total acres reclaimed for the report year:* <br />6. Total number nf..acres..in topsoil replacement stage :_ <br />a. Average thickness of topsoil replaced: <br />7. <br />8. <br />9. <br />10 <br />11 <br />Total number of acres seeded: <br />a. List species seeded & seeding rate for report year on back <br /> <br />YES NO <br />MO L SS <br />YES NO <br />G <br />For non-phased operations provide dates extraction ceased: _/Y /f~ <br />a. Date reclamation began: ~~ /r/~ <br />The type and approximate quantity of fertilizers, organic material or soil f <br />conditioners used for the report year:* <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. For phased operations show dates extraction ceased and dates <br />reclamation began. <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 6, then a new map is unnecessary. However, this must be stated above. <br />Signature: ~ ~~ Date: ~ ~ ~. / yCf <br />Please type or print current contact name, mailing address, and phone n~u5mber below: <br />Contact Name : ~~ fG<!~ r Phone: ( ~/~) iT S ,~- .~'T 3 <br />FAX NO: ~%l/ ) ~. <br />Company: ~l/,I -f(.(IG s (-/7ti~vc~'~P~ Luc <br />Address: ~!~' ~( ~G~ <br />Federal Tax ID No. or Social Security No.: -/ ~ <br /> <br />Estimated total acres to be affected in the next report year:* ' <br />