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<br />~ III IIIIIIIIIIIIIIII ~ -p <br />Notice of Intent ~~ ..,,,.999.__• ]g Operation{ ~~! ,, ,~~, <br />112 Annual Report ~- <br />Permittee Name: Western Mobile Northern Inc <br />Permit No: M-85-026 <br />Operation Name: Challenger Pit* <br />Anniversary Date: 01/31/92 R^" <br />Total: $430.00 (Due on your Anniversary Date; <br />Has your mine been granted TEMPORARY CESSATION STATUS? <br />Does your mine operate MORE or LESS than 180 days per year? <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 seeded & seeding <br />rate for report year on back <br />5 <br />JAN 0 9 1997 <br />MinP~i Laid <br />tlr.-, <br />YES <br />MORE LESS <br />Topsoil replace <br />Average topsoil thickness <br />replaced: <br />The type and approximate quantity of fertilizers, organic mat¢rial 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: NO CHANGES SINCE LAST REPORT. _ <br />* Please show the location of the acreage for items 2 - 6 on you map**. <br />Indicate the phases of the reclamation which have been complet d, correlated <br />with your timetable. <br />NOTE: If there have not been any changes since the last annual r port and <br />you previously submitted a map which correctly depicts the Curren acreage in <br />items 2 through 6, then a new map is unnecessary. However, you m st state this <br />fact above. <br />Signature: Th~~1/~Q, ~~, o Date <br />Please type or print current contact name, address, and phone <br />Contact Name: MICHAEL D. SHEAHAN P one: ( 3a <br />Compdny: WESTERN MOBILE NORTHERN. INC. <br />Address: P.o. sox 2187 <br />FORT COLLINS. CO 80522 <br />Federal Tax ID No. or Social Security No.: <br />~' ~ <br />er below <br /> <br />~~ <br />`1 <br />