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<br />~iotiCa~Q`~?ntent to Cort.im.? ~ininc C.e-a`~o,s ~n.
<br />'~ - 1}Ot2) Annual Resort _
<br />Permittee Name: ~D~-ts~ Const~.vct;c,~ '?; }
<br />Permit No: ~ h1 t9R6- o.~?.
<br />Operation Name:
<br />Anniversary Date: `~a~'Y.°``'
<br />Lotai; S <Gue.on your Anniversary )ate)
<br />1. a. Permitted acreage: , (~sr~-ks~. County whsre min£ is ocaied: jRt~~~'~'
<br />Z. Nas tr,is mine been granted TEMPORARY CE55A?iCN STATUS? YES No
<br />Ooss this mine ope•ri<te MORE or !ESS tha:~ i8G days par year' ,}{Cn~ =ESS
<br />Do you .extract NpOrt£, or 1E55 tttan.)G,09C tons o` r,.4nera? or ~---~
<br />overburden a year? SCR` "'S
<br />3. --goer-thfs-minq'tiava a-pha§2d r.eciaaat'~o.^. p?~;? ____.___. .-.- - ~ hC
<br />g. Tote? acres aYfected'dur.fnq ilia report year:* _._c2~ ~ ~.._
<br />5,, Potal acres reciair„„$d °cr *,he:report yea^:' ____~4_~ °.__,
<br />c. 3ot3?`acres 6ti various stares of rec?a~Tation:'
<br />a. So.tk*ii}ed: d. ?opsoi' reptace~':
<br />b. Graded: Average topsoil thickness
<br />c. See.d$d• repiac£d: ,~,
<br />. ~ lfst ipec.te; seeded. & s4e~ing
<br />,rate for report year on 4a:k
<br />7. Itte type and approxtmate goantf.ty of fert'<'•.zers, oryanc ma:£r1e.? cr sc?'
<br />conditioners used fpr:'th.e re xrt year:'
<br />' 8. Estimated tote?"acres to be affected !n the next report year :2.'; a
<br />S; COHMENTS: _.rA. ntir~vs~ wc-~.~.:~ ;,,~ S_fo, ~< r v+.2 ____ _
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<br />~' ~~ ??ease SY,ow the ?oration:of the acrea,£ f0?' %t£G!s ~' - E O^ yC+'.' r:ap}i•
<br />.. IndSCate 'titB gnaws `og tta@<r@C}ar12tSC~~W~'?iCh tldVg }JR?(`. CC:!"r?4hBL~. :?rrEid°°i 4f~`!t
<br />_.. ` V9Vr ":-'etriS4di31B --:-~ - -~- __. _ ~ ~ ~r-_ _,_ --
<br />;'° flU~,E. Tf ~ titflt'e ~:dYe '?~..tleBn aft; ChaS?C~2i. S;~C2 the ?25t an1Ud.+ -"2~0?'t an'~ y^',
<br />~~ pretiiQUSiy. suba~i~e~:a ntap v~st~h, correc`.iy d@elcts ti:e Curront aCr: aka i,. ?':;~!;; ;.
<br />through'5, t>Apn a ne;+c rti~p #d unrpcessar:y. uewevEr, this ^ust be sated a~.ve. -
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<br />' Signature: ,,,,_,,. ~ gate: _ .
<br />x-. __
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<br />Please type or prf~t :urrert contact nape, r.:aiis,q address, and p±:o1e number ~eiow:
<br />M'o~Wtr ,
<br />~ ,
<br />r i~mtact Na~e>? . 'ir1C~~~tt.r.~ ~.~.C,.~,;~~.lg_ Phone: ~~IO~,~~~-.~t.%a't.~...
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<br />federal T,ax'ID. Ao:.o.;. Soct~i SR~arity \p.~ ., .,._ .,___.T_ , .___
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