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• iii iiiiiuiniii iii <br />999 <br />ANNUAL REPORT <br />PERMITTEE NAME: City of Lamar <br />PERMTI' NO.: M-84-154 <br />OPERATION NAME: Well Field Pit <br />ANNNERSARY DATE: December l0, 1999 <br /> <br />~~ <br />~~CEIVED <br />tVOV 16 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 "~'sion of Minetal~ & Geology <br />COUNTY: Prowers <br />According to C.R.S. 34-32.5-1 16(3)(x), each year, on the anniversary date of the permit, an operator <br />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 <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for [he year, <br />if any. <br />Please attach Your revised annual report map and written report to this annual report. Please <br />note that an adequately labeled amp dial clearly deliirentes and includes the above elements may <br />sn~ce for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: Patrick Mason <br />Company: City of Lamar <br />Adddress: 102 E. Parmenter Phone No.: (719) 336-4495 <br />Lamar, CO. 81052-3239 Fax No.; p1 9 )336-9904 <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a sepazate sheet and attach it to [his report form along with your map and/or written <br />report. <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />