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<br />}'V~ - ~ c~~~5~ 02 3 ~ t <br />~ t u ~ i n _ ,.: . <br />J <br />Z~ot1C8~Q, sntent to t:on.ic±u? ..;n,^~ ..,e.a..o.s .., <br />• ~ 17Q{2? Annual Retort _ RE <br />CEIV <br />Perm{ttee Name: -'~ Coy-~+{ C~+.st~.wcb;a,'?;~- Ep <br />Permit No: ~ M 194x. a~~ <br />~ <br />tto <br />N <br />Op y SEP78 ~ <br />e <br />n <br />ams: <br />a <br />~rsary Date: ~Urvism^ <br />5225.00 t0ue on your Anniversary 1d <br />0f M'^eralsandCe°~°Q~ <br />Totat <br />~or-k s~• County where mine is <br />1. a.'Permttted acreage: ocated: ~}a ~ ~-~~`n <br />, <br />2. lfas this mine been granted TEMPORARY CESSATLCI~ STAT',;S? YrS NO <br /> <br />Ooeg this mine operate MCRE or !ESS thdn iS0 days par year' ,t+fo~~ HESS <br />Do you .extract N,ABE or LESS than 7C,000 tons o` mineral or <br />overburden a year? ?nORi 1ESc <br />3. Does: this mite have a phased rsclac:aticn year.? -- - - Yc5 1r'0 <br />4. Total acres aftecte? daring the report ysar:r ~~`~~~ <br />5. Total acres reclaimed `cr the report yea.~;* ~~,.Q_no•__„ <br />c. Total ernes 1tt various stage: of reclamation:' <br />• a. Backf111ed: d. +'opscii rep ace !': <br />b. Graded: Average topsoil thicFness <br />• c. Seeded: replaced: _ , <br />List specie; seeded & seeding <br />,rate for report year on flack <br />7. The type and approximate ~uartp.ty o` fert`iizars, organi: ra:eria.: cr sci': <br />condit9oner; used for ,t1~e report year:' <br />$.'' Estimated total" acres to be affected in t!:R next repent year ~ -?.^ ~.tO <br />s; cortol~Nrsc _C;f,~~~nu`~ ~~~..&.~~ ;,., 5~~c~~w2 , <br />'~•~~ Pieria show the lbtatten.o` the acreage fo:• items a - E o~ yc~r r;ap.. <br />Endtcats the g:?as+es 4!' the r.eclaaz;•~en Lf~±Cll haY$ been Cp!^~labp~, ;7rr2!d'?~`. Ni `;`! <br />..: ' . ,. <br />*• ~~: ~'4# - ther2 :i:dYS ;:qt, .been any C1;dP.g~i. S i nC2 the i a^"> t an~Ua ~rep0r t anu V9:% <br />~' &reX1GZ~S1y.5L'~[~1~';@~,~+ REdp VfIS!~, COt"rQC`iy de:1CC5 t~2 Current ar":~~D to ?i?m$ i <br />throlsgh 5, tt:?h a ne~t!RdQ'1'a ittfT?G@ Sa'y• i?C~weVe", t;,iS ^iiS`. bC 5'at°`~ a'~wYB• - <br />Signature ~ .oats: ~~ ?~~ <br />.~ <br />x--~-------~-c--' - _... <br />Please type or priz,currert contact nape, r.^.aiis:sg ;duress, a.nd ;.hcze .number be:cw: <br />i,.i ~; ~i~dCt ~d'Ce:. S ~iatQ_ Rhone: ~~t) n~~-. <br />.,.. _ <br />,~i?xCd..~i~ , {lc~i . 8'4 g• <br />ederaJ. Tax ID rtc..: or. Social Ss<urity s~'q, • „_ ~`~'l~aD©l <br />