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~, III IIIIIIIIIIIIIIII <br />,% <br />ANNUAL REPORT <br />PERMITTEE NAME: Forest Lakes Metro District <br />PERMIT NO.: M-81-158 <br />OPERATION NAME: Forest Lakes Pit #1 <br />~~-~G ~~ <br /> <br />1a~..I~o;~~F <br />ic~9 <br />'DECEIVED <br />.JAN 14 1999 <br />ANNIVERSARY DATE: January 26, 1999 t)ivi...=. .iMinerals&Geology <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: La Plata <br />Please attach to this annual report your revised annual report map and written report. Note that a written <br />report is not necessary if the m:ap addresses all the items listed in the attached instructions <br />concerning mining disturbance and reclamation update. Also, if all of the reportable conditions listed <br />in the Annual Report instructions have not changed since the last Annual Report map and report were <br />submitted, then a revised map is not required. Please indicate [he correct response below. <br />UPDATED MAP ATTACHED <br />^ CONDITIONS UNCHANGED, LAST SUBMITTED MAP REFLECTS CURRENT CONDTTIONS <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: ,/ <br />Contact Name: A~ /~ ~'Tz- Company: ~~T ~'~ ~~~ ~~~Q~T <br />Address:: ~-~• 8oX ~rf 8 Phone Nn.: (97~ ) ~~ Z9Z S <br />~6ar~~/~, (b diiiz7 -~o~Fda Fax No.: (~70 ) ~ ~3~5 <br /> <br />Signature of <br />or Owner <br />/z p y <br />Date <br />M.~DN R M LNIASTERDU7-AF-03. <br />