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re a <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />t/ Mine Development, Inc. <br />t/M-1981-165 <br />Neglected Mine <br />October 2, 2006 <br /> <br />RECEIVED <br />~ SFP ~ a ~nn6 <br />~Dlvlslon of Reclamation, <br />Mlnlnq and Safety <br />$225.00 (Due on or before your anniversary date) <br />La Plata <br />_ _ ,According to C.R.S. 3432.5-116 or_C.R.S. 34_32=116, each yeaz,9n-the.anniversary_datemf the~ermii,_an_ _ ___ ~__ <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual reuort man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, reuort, and <br />associated map. If no new disturbances or reclamation have occurred during the previous vear and no <br />new chanties to the previous year's moo are necessary, then no new moo is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Harold E. Lunar <br />Permittee Name: <br />Address: <br />. ~,~~~ <br />Mine Development, Inc. <br />3319 E. 4th Ave. <br />Durango, CO 81301 <br />Phone Number: (970) 247-1652 <br />Fax Number: (281)578-3159 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />~~ <br />Signature of Corpo t fficer, Owner, r Designee <br />Dale <br />M:~PEAMITMASTERDOCUMENTS/M-AE-02.DOC <br />