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Notice of Intent to Continue m,n~~~y Operafions <br />110(2) Annual Report Minadl_and <br />Reclama.ion Division <br />Permittee Name: David Goss <br />Permit No: M-85-140 <br />Operation Name: Goss Sand & Gravel <br />Anniversary Date: 01/24/91 <br />Total: E50.00 (Due on your Anniversary Date) <br />Please return this Annual ReDOrt form with your completed Map** ,and a <br />check or money order for annual fees due, payable to the Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />1. Has your mine been granted TEMPORARY CESSATION STATUS? YES NO <br />Does your mine have INTERMITTENT USE STATUS during the year? YE '~ NO <br />2. * Total acres affected during the report year: ~_ <br />3. * Total acres reclaimed for the report year: ]2~-rti~ <br />4. * Total acres in various stages of reclamation: , n _~y <br />a. Backfilled: d. Topsoil replaced: <br />b. Graded: Average topsoil thickness <br />c. Seeded: replaced: <br />List species see~e 8-seeding <br />rate far report year on back <br />5. * The type and approximate quantity of ferti 'ze s, orga m c material or soil <br />conditioners used for the report year: <br />6. * Estimated total acres to be affected in the next report year: ~ <br />* Please show the location of the acreage for items 2 - 6 on your map. The <br />map shall be to a scale of not less than 100 feet to the inch and not more <br />than 660 feet to the inch. Indicate the phases of the reclamation that <br />which have been completed, correlated with your timetable. <br />** NOTE: If there have not been any <br />you previously submitted a map which <br />items 2 through 6, then a new map is <br />fact in your current annual report. <br />Signature: <br />changes since the last annual report and <br />correctly depicts the current acreage in <br />unnecessa~~ry~~JJ However, yo must state this <br />~~ Date: _1 2. /- ~ Z - ~ O <br />Please type or pr,nt current contact name, address, and phone number below: ~ <br />Contact Name: <br />Address: <br />one: (~~ 9) ~~~" o~-~ ~ ~/ <br />V ,C~ <br />W <br />`, \~\~ <br />Y\~ <br />