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__ _ • <br />Notice of Inten III IIIIIIIIIIIII III ng Operations <br />110c Construction Materials Annual Report <br />Permittee Name: David GOSS <br />Permit No. M-85-140 RECEIVED <br />* <br />Operation Name: Goss Sand & Gravel <br />Anniversary Date: January 24, 1997 <br />Total: $225.00 (Due on your Annivers ) <br />~~~ ~~ <br /> <br />1. <br />a, Permitted acreage 1997 <br />r <br />e mine is located <br />: ~ ~ b. County whe <br />: ~ ~ PN-5 ~ <br />2. Has this mine been gr n <br />~~ <br />anted TEMPORARY CESSATION 9TATL75~?f i,niitid,y a heV~OJy ES NO <br /> <br /> Does this mine operat e MORE or LESS than 180 days per year? MORE LESS <br />3. Does this mine have a phased reclamation plan? YES NO <br />4. Total acres affected during the report year:* - ~ <br />5. Total acres reclaimed for the report year:* - O ` <br />6._ Total number of acres in topsoil replacement stage: __. _ _ - ~ ~-- _ <br /> a. Average thickness of topsoil replaced: _ ~ <br />7. Total number of acres seeded: ~' ~ <br /> a, List species seed ed & seeding rate for report year on back <br />8 <br />9 <br />For non-phased operations provide dates extraction ceased <br />a, Date reclamation began: <br />Y1r1,~-~ s~tc~.~, <br />' I ll <br />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* <br />10. Estimated total acres to be affecte9d in the next~ Lreport year:* <br />11 . coMMErrrs : ~ ~ S ~ /.1 h h N tY / ~ ~~ -~ n r I ~ Y1 ~ . h1 ri : ~ X --~.P" !_, <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 />*+ NOTH: 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 w map is unnece sary. However, this must be stated abopve. <br />p ~7 <br />Signature: ~-~ Date: <br />Please type or print current contact name, mailing addres and phone number below: <br />~~..!! r <br />Contact Name: cy /~ J Tc? . i <br />Company: ~'r0 5 S ~ )~F( ~~~ 7~''l//`S YC~~//U r'~ <br />Address: ~ 7S~ ~: ~/ 1 C.BTI~ [~-C <br />(_~_11,~!~ ~~~ Z~1TD~~ <br />Federal Tax ID No. or Social Security No.: <br />Phone: ( /~/ ) li~ "~7~;5n <br />FAX NO: (7 ~ 9 ) 4 ~3 ~~ 2 7 <br />