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III IIIIIIIIIIIIIIII <br />Notice of Intent to Cnntin~~e Mining ons ~C " ~1 ~, <br />112 Annual Report ` ~ <br />Permittee Name: Western Mobile Northern Inc Jq N 0 g 199? <br />Permit No: M-77-439 ~^^ rMippn <br />Operation Name: Home Office Mine ~-•-,1i~ ~h~d <br />Anniversary Date: 01/31/92 <br />Total: $430.00 (Due on your Anniversary Date) <br />1. Has your mine been granted TEMPORARY CESSATION STATUS? YES NO <br />Does your mine operate MORE or LESS than 180 days per year? ( MO ER LESS <br />2 <br />3 <br />4 <br />5 <br />Total acres affected during the report year:* <br />Total acres reclaimed for the report year:* <br />b. Graded: .75 <br />c. Seeded: -o- <br />List species seeded & seeding <br />rate for report year on back <br />Total acres in various stages of reclamation:* <br />a. Backfilled: _75 d. Topsoil replaced: <br />Average topsoil th'ckness <br />replaced: <br />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 />7. COMMENTS: <br />* Please show the location of the acreage for items 2 - 6 on your map**. <br />Indicate the phases of the reclamation which have been completed, correlated <br />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 ac~•eage in <br />items 2 through 6, then a new map is unnecessary. However, you must ~~tate this <br />fact above. <br />Please type or print current contact name, address, and phone number t~elow: / <br />1 ~` <br />~\ <br />Federal Tax ID No. or Social Security No.: <br />Signature: ~~f1'~~~ Date: _/~ ~ " Y ~- <br />COntdCt Ndme: MICHAEL D. SHEAHAN P ~ne: ( "109 ) 482-7854 <br />Company: WESTERN MOBILE NORTHERN. INC. ~ ~ / <br />Address: P.O. BOX 2187 ~ ~~ <br />FORT COLLINS. CO 80522 <br />