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~II ~I~~I~~I~~I~~~I~ Notice of Intent to Continue Mining Operation ~~~c11/L-a 110(2) Annual Report Permittee Name: Don Kehn Construction Inc 1L U 1199"r Permit No: M-86-074 Mir Operation Name: Dollerschell* ReCl2 m ed LBnd Anniversary Date: 06/30/92 or^~ Total: $120.00 (Due on your Anniversary Date) 1. Has your mine been granted TEMPORARY CESSATION STATUS? YES NO Does your mine operate MORE or LESS than 180 days per year? MORE LESS 2a. Financial Warranty: $ 2b. Permitted acreage: ~p 3. Do you have a phased reclamation plan? YES NO 4. Total acres affected during the report year:* / 5. Total acres reclaimed for the report year:* O 6. Total acres in various stages of reclamation:* n/ o n/-F a. Backfilled: d. Topsoil replaced: b. Graded: Average topsoil thickness c. Seeded: replaced: List species seeded & seeding rate for report year on back 7. The type and approximate quantity of fertilizers, organic material or soil conditioners used for the report year:* ,~ r,4 8. Estimated total acres to be affected in the next report year:* /n 9. COMMENTS: * Please show the location of the acreage for items 4 - 6 on your map**. Indicate the phases of the reclamation which have been completed, correlated with your timetable. ** NOIE: If there have not been any changes since the last annual report and you previously submitted a map which correctly depicts the current acreage in items 2 through 6, then a new map is unnecessary. However, you must state this fact above. p n ~ Signature: ~~_~ „, ~~L,.,-, .~a~./~.~~, Date: !P/3o/9~ Please type or print current contact name, mailing address, and phone number below: ~~ Contact Name: m„ xPr,~ Phone: ( 3A3 ) 226-4111 Company: ~ Kehn ConstYUCtion, Iqc.. . Address: F37z Rnuth r}l1~Pl)P Ft. Collins, ~ 80525 1 ~ / Federal Tax ID No. or Social Security No.: 84-0759732 Jv~\,~\~(~