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~ • IIIIIIIIIIIIIIIIIII • ~ECEIVE~ <br />Notice of Intent to Continue Mining Operations <br />110(2) Annual Report lUL 0 6 199 <br />Permittee Name: M Sims Gravel Company Mined Lang <br />Permit No: M-87-103 Reclamation Div <br />Operation Name: East Douglas Pit isl0n <br />Anniversary Date: 08/24/92 <br />Total: $175.00 (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? MORE LESS/ <br />2a. Financial Warranty: 8 d 0* 2b. Permitted acreage: <br />3. Do you have a phased reclamation plan? YES NO <br />4. Total acres affected during the report year:* -- <br />5. Total acres reclaimed for the report year:" -' <br />6. Total acres in various stages of reclamation:" <br />a. Backfilled: 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 />7. Thr~ type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* <br />8. Esi:imated total acres to be affected in the next report year:* ~X~.CY~ e <br />9. IICOhIMENTS:~~,dDD.~°.~a-a el.i-: ~.~e~ ~~~-7B~.D0 -~- ~ic~i _ ~.Jtlu~ ~/1~~ <br />I~~~." n..l. ._i~~ `._ SAL.... 1409 I ~tJ no ~ w ~. ~. l.~n h ~ _..~ <br />~.1 e.~',.,~,, `uJ:,~1-! ,~1.~>cy~. 7A1~1w.. Ou+n.l .gyp. wt .~~- ./l..i. s~~-1w ~ _ <br />* Pled3"e s ow the location of "the acreage or items 4 - 6 on your map"*. <br />Indicate the phases of the reclamation which have been completed, correlated with <br />your TTtimetable. <br />** N~IE: 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: G~ ~..¢J Date: ~ 2, / 9 9~, <br />Please tripe or print current contact name, mailing address, and phone number below: <br />Contact Name: Phone: (,3G3 > ~ 75-z 3 ~ ~ <br />Company: <br />Address: <br />Federal Tax ID No. or Social Security No.: ~I~bS'1.3,J 2 <br /> <br />~~ irJ <br />,~1~1 <br />