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` ~ • III IIIIIIIIIIIII III • <br />999 ' 7 ~i~ ~-. ~ <br />Notice of Intent to Continue Mining Operations Q <br />112 Annual Report ~~16 /gg~ <br />''/: /~ ~. <br />Permittee Name: Mathias Concrete Inc <br />Permit No: M-77-140 <br />Operation Name: N Farm Rd Pit No 1* <br />Anniversary Date: 01/15/94 <br />Total: 5550.00 (Due on your Anniversary Date) <br />1. Has this mine been granted TEMPORARY CESSATION STATUS? YES NO <br />Does this mine operate MORE or LESS than 180 days peg yea.'? MORE LESS <br />2a. Financial Warranty: $ ~~ 2b. Permitted acreage: <br />3. Does this mine have a phased reclamation plan? Y 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 <br />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* ' <br />8. Estimated total acres to be affected in the next report year:* ~~ <br />9. COMMENTS: <br />P.I <br />* Please show the location of the acreage for items 4 - 6 on your map**. <br />Indicate the phases of the reclamation which have been completed, correlated with <br />your 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: Date: ~2'-~~ J <br />-T <br />Please type or print urrent contact name, mailipg address, and phone number below: <br />Contact Name: ~~ Phone: ( 7/~) ~~o2-c~/3Z <br />--• <br />Company: <br />Address: <br /> <br />Federal Tax ID No. or Social Security Nc~.: S d~ -[~j ~- ~ ~J S <br />"1~ <br />\~\`~\ <br />