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1, _ ' iii iiiiiiiuiiii iii ~ .. . 999 R~~EIVED Notice of Intent to Continue Mining Operations 112 Annual Report- _ MAR ~ 3 ~9~~ Permittee Name: Weld County Permi t No: M-81-286 Division of Minerals 8 Geology Operation Name: Thomas Gravel Pit 4* Anniversary Date: 03/01/96 Total: $550.00 (Due on your Anniversary Date> 1. a. Permitted acreage: ~7,(~ b. County where mine is located: :.'~~./~~~d 2. Has this mine been granted TEMPORARY CESSATION STATUS? YES Does this mine operate MORE or LESS than 180 days per year? MORE LESS 3. Does this mine have a phased reclamation plan? YES NO 4. Total acres affected during the report year:* (~ 5. Total acres reclaimed for the report year:* C) 6. Total acres in various stages of reclamation:* a. Backfilled: -g d. Topsoil replaced: b. Graded: '-' Average topsoil_thickness c. Seeded: '- replaced: List species seeded & seeding rate for report year on back 7. The type and approximate quantity of fertilizers, organic material or soil conditioners used for the report year:* 8. Estimated total acres to be affected in the next report year:* - 9. COMMENTS: (A_.~ ~,,~~ ~,~~~ m ~t ~ ~.~ cy~ zT,~f s{ac.(:~~ /I/r c?! r i * Please show the location of the acreage for items 4 - 6 on your map'*. Indicate the phases of the reclamation which have been completed, correlated with your timetable. *' NOTE: If there have not been any changes since the last annual report and you previously submitted a map which correctly depicts the current acreage in items 2 through 6, then new map is unnecessary. However, you must state this fact above. Signature: ~~ ~/,,~,_ Date: ,~. ~Cr ~vl.- Please type or print current contact name, mailing address, and phone number below Contact Name: C~ /L/~jr,~., / Phone: Company ~~- F-~ ~L~e./,~ ~,~..: ~~ I~ ll,I. 4,~t.k5 Address: /n~'rr-z-z' f~'U PJOx 75 FT L Y C. LIGY ~C~fOL~ ~i .~ ( `77J) 35~-Nc.~ x 3is~ Federal Tax ID No. or Social Security No.: ~1/-(,QQp - ~(_3