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<br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />Notice of Intent to Continue Mining Operations R F C FIVE D <br />110(2) Annual Report <br />B,~.P 861 <br />Mike Coleman and Jerry Seifert <br />M-91-083 i;,, .,.;,,, ,,, ,.,,uerais tiGeofpgy <br />Ula Pit* <br />10/29/94 <br />$225.00 (Due on your Anniversary Date) <br />1. Has this mine been granted TEMPORARY CESSATION STATUS? <br />Does this mine operate MORE or LESS than 180 days per year? <br />Do you extract MORE or LESS than 70,000 tons of mineral or <br />overburden a year? <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />YES <br />MORE ESS <br />MORE ES <br />YES NO <br />ID <br />a. Backfilled: n d. Topsoil replaced: ~ <br />b. Graded: O Average topsoil thickness <br />replaced: ~ <br />c. Seeded: D <br />List species seeded & seeding <br />rate for report year on back <br />Does this mine have a phased reclamation plan? <br />Perm'tted acreage: <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 />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* Ylohe <br />Estimated total acres to be affected in the next report year:' <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 timetable. <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: ~)~~,~ J~ -~~o~.A„__~ Date: 9/21/94 <br />Please typfa or print current contact name, mailing address, and phone number below <br />COntatt Ndne: Jerald A. Seifert Phone: (719 ) 783-2757 <br />Company: Custer County Concrete <br />Address: P.O. Box 305 <br />Westcliffe, CO 81252 <br />~ ,99a <br />`ti <br />Federal Tax ID No. or Social Security No.: <br />