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999 RECEIVED <br /> Notice of Intent to Continue Mining Operations <br /> 112 Annual Report Nov 08 1996 <br /> Permittee Name: Asphalt Paving Company <br /> Permit No: M-83-089 <br /> Operation Name : Tomah Site* ,hvww urnunCrd�5&Geology <br /> Anniversary Date : 11 /08/96 <br /> Total : $550.00 (Due on your Anniversary Date) <br /> 1 . a. Permitted acreage : �b. County where mine is located: _L�-5 <br /> 2. Has this mine been granted TEMPORARY CESSATION STATUS? YES 6 <br /> Does this mine operate MORE or LESS than 180 days per year? MORE qD <br /> 3. Does this mine have a phased reclamation plan? ES NO <br /> 4. Total acres affected during the report year:* <br /> 5. Total acres reclaimed for the report year: * <br /> 6. Total acres in various stages of reclamation:* <br /> a. Backfilled : d. Topsoil replaced: 0 <br /> b. Graded: Jr— Average topsoil oTckness <br /> c. Seeded: p replaced : xze <br /> List species seeded & seeding <br /> rate for report year on back <br /> 7. The type and approximate quantity of fertilizers , organi material or soil <br /> conditioners used for the report year:* <br /> 8. Estimated total acres to/be affected in the next report year:* ; �F <br /> 9. COMMENTS: rr;ale .J� p_f.ov �o CO Ale' S� <br /> /1/a �'�c-ot 1/f1 v o OGGLI,L'�O i <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 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 unne essary. However, you must state t is fact above . <br /> Signatu : Date : <br /> :�or <br /> i/ <br /> Please print current contact name, mailing address , and phone number below: <br /> Contact Name: Q�,se- S ^tea vt9�e� Phone _2 ?:e- <br /> Company: <br /> Address : <br /> ''3// <br /> Federal Tax ID No. or Social Security No. : 8�`CS`�f�/L� <br />