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III IIIIIIIIIIIIIIII` • <br />sss <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />Notice of Intent to.-ConfTnue Mining Qper ~~~~~~ <br />112 Annual Report <br />Jake Kauffman ~ Sons Inc <br />M-78-327 <br />v~~R i e iQ9~ <br />Kauffman Pi t* Mln6d Ld-Yd <br />05/14/92 Reclamation ~+„~,:~.., <br />$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 160 days per year? MORE LESS <br />2. Total acres affected during the report year:* /0 ~Z <br />3. Total acres reclaimed for the report year:* L~~Z <br />4. Total acres in various stages of reclamation:* <br />a. Backfilled: ~ Q e5 d. Topsoil replaced: <br />b. Graded: Average topsoil thickness <br />c. Seeded: replaced: <br />List species seeded & seeding <br />rate for report year on back <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 />7. COMMENTS: <br />* Please show the location of the acreage for items 2 - 6 on your map**. Indicate <br />the phases of the reclamation which have been completed, correlated with your <br />timetable. <br />NOTE: If there have not been any changes since the last annual report and you <br />previously submitted a map which correctly depicts the current acreage in items 2 <br />through 6, then a new map is unnecessary. However, you must state this fact above. <br />Signature: llimm~~ ~Pr?17(D .S2G~T~PI-+ . Date: ,.3 /~C - J~ <br />Please type or pr,int~current contact name, address, and phone number below: <br />Contact Name: I~IIYlf11c4 PE0lJ10 ~j Phone: (303) /~l~7-/55~ v <br />Company: -ice/( FCman And.S~,u, L+~, <br />Address: ~_ <br />lnve)an~l, n. >3oss7 <br />Federal Tax ID No. or Social Security No.: B~I-D56071y <br />