2001-05-23_REPORT - M1983030

• Permit No: M1983030
• IBM Index Class Name: Report
• Doc Date: 5/23/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Westley Potts
M-1983-030
Twin Canyon Mine
June 10, 2001
RECEIVED
MAY 2 3 2001
Division of Minerals and Geology
$75.00 (Due o0 or before your anniversary date)
Montezuma
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
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances tlrafare anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual resort and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice jor a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Westley Potts
Permittee Name: Westley Potts
Address: 81 IS CR 41
Mancos, CO 81328
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
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Signature of C rate fficer or Owner
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Date
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