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ii iiiiiiiiiiiu iii <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />Notice of Intent to Continue Mining Operations nCl ~ $ T99s <br />112 Annual Report <br />~.~^,~~,,. c. <br />Dorn Ready-Mi x Corp " ~~~ • .,~ „ <br />M-74-092 ~"~ <br />Barlow Pit* <br />10/31/96 <br />$550.00 (Due on your Anniversary Date) <br />a. Permitted acreage: b. County where mine is located: _ <br />Has this mine been granted TEMPORARY CESSATION STATUS? YES <br />Does this mine operate MORE or LESS than 180 days per year? MORE <br />Does this mine have a phased reclamation plan? YES <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 />a. Backfilled: d. Topsoil replaced: <br />b. Graded: Average topsoil thickness <br />c. Seeded: replaced: <br />List species seeded & seeding <br />rate for report year on back <br />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* <br />Estimated total acres jp be affected in the next report year:* <br />9. COMMENTS: <br />* Please show the location of the acreage for items <br />Indicate the phases of the reclamation which have been <br />your timetable. <br />** N~1E: If there have not been any changes since the <br />previously submitted a map which correctly depicts the <br />through 6, then a new_map is unnecessary. However, yo <br />4 - 6 on your map**. <br />completed, correlated with <br />last annual report and you <br />current acreage in items 2 <br />~ must state this fact above <br />Signature: ~~~~%~ ~~u~ Date: /O~ ~/ /~ <br />Please type or print current contact name, mailing address, and phone number below <br />Contact Name: Phone: (/7~ ) `f~~1~lO~ <br />Company: <br />Address: <br /> <br />NO <br />LESS <br />NO <br />Federal Tax ID No. or Social Security No.: ~~ y ~ Z"~~g <br />