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i-1 .!i~. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />J-Rude, Inc. <br />M-1989-009 <br />J-Rude Inc <br />March 17, 2002 <br />~~~E~~E° <br />~D ~ 32002 <br />t:':H~ <br />,~ivis+nn °t Minerels and Geolo9Y <br />$281.00 (Due on or before your anniversary date) <br />Prowers <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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />-° --reclamation-accomplis}ted-b-dah-and-during-the-preceding-year-new-disturbances-tftai-are anticipated-to-occur--- <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual reuort map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Rudy Torres <br />Permittee Name: J-Rude, Inc. <br />Address: 1750 CR HH <br />Phone Number: <br />Lamar, CO 8]052 <br />(719) 336-7361 <br />Fax Number: <br />If you have additional comments and/or information that should 6e 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 enclosed. <br />r~ <br />Signatur of Corporate Officer or Owner <br />_~~©~~z . <br />Date <br />MdPERMn~MASTERDOCUMENTSVvI-AF-01 <br />