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III IIIIIIIIIIIII III • <br />999 <br />:i Notice of Intent to Continue Mining Operations <br />+ 112 Annual Report <br />ncv ~ ~ i~~o <br />Permittee Name: Mathias Concrete, Inc. <br />Permit No: M-77-140 ~' `'"r ~-=~'~' <br />Operation Name: N Farm Rd Pit No 1 F,aClama~ion ~~i~~;sion <br />Anniversary Date: 01/15/91 <br />Total: E350.00 (Due on your Anniversary Date) <br />Please return this Annual Report form with your completed Map*~ ,and a <br />check or money order for annual fees due, payable to the Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />1. Has your mine been granted TEMPORARY CESSATION STATUS? YES NO <br />Does your mine have INTERMITTENT USE STATUS during the year? YE NO <br />2. * Total acres affected during the report year: <br />3. * Total acres reclaimed for the report year: <br />4. * Total acres in various stages of reclamation: <br />a. Backfilled: ,/~ d. <br />b. Graded: ~,` ~ <br />c. Seeded: <br />List species see~e3-& seeding <br />rate for report year on back <br /> <br />Topsoil replaced: <br />Average topsoil thickness <br />replaced: <br />5. * The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year: ~} <br />6. * Estimated total acres to be affected in the next report year: _~ <br />* Please show the location of the acreage for items 2 - 6 on your map. The <br />map shall be to a scale of not less than 100 feet to the inch and not more <br />than 660 feet to the inch. Indicate the phases of the reclamation that <br />which have been completed, correlated with your timetable. <br />** NOTE: If there have not been any changes since the last annual report and <br />you previously submitted a map which correctly depicts the current acreage in <br />items 2 through 6, then a new map is unnecessary. However, you must state this <br />fact in your current annual report. ~Gl~6ove~,nT e~/~~ye.6 ~~f F~ ~eJ~~~ `~P~~s <br />-L~i /~ ~ v~A~e~-fie gar r i~ ve~~f fa ~0l/C~[.il-~ <br />Signature: ~-~rr~l~'~~~-~° Date: ~~ ~~ ~~ <br />Please type or print current contact name, address, and phone number below: / <br />Contact Name: _~~~-f-~~;;~y Phone: (7/~J ) ,~~a-~J.~ v.// <br />Address: ~~~~/i / <br />-T ~ ~ o / // <br />n.~,d <br />~V '~ ~la~ <br />