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RECEIVED <br />PERMITTEE NAME; <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />EI Paso County <br />M-1980-194 <br />Aodgen <br />October 23, 2002 <br />OCt 2 12002 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />EI Paso <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />- operator-shall-submit-the-annual-fee, a-report-and-map_showing_the_ex[entof current_disturbances_to_affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated [o <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 report mao to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permi[tee contact information. Please verify and make any necessary <br />changes: <br />Permiuee Contact: George P. Sugars <br />Permittee Name: El Paso County <br />Address: 3460 N. Marksheffel Rd. <br />Colorado Springs, CO 80922 <br />Phone Number: (719) 520-6460 <br />Fax Number. (719) 520-6878 <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 />O ~~ <br />Signature of C rporate Offic ,Owner, or Designee <br />l f~ / 2f/ O Z <br />Dale ~ <br />M:NERMITUTASTERDOCUMENTSN~7-AF-04 <br />