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• ~iiiiiiiiiiiiiiuiii <br />=s- 999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Kit Carson County <br />PERMIT NO.: M-82-186 <br />OPERATION NAME: Beeson Pit <br />ANNIVERSARY DATE: October 28, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Kit Carson <br /> <br />RECEIVED <br />., .. <br />n r-I 4 /. LCin,, <br />piNyon of Minerals & Geobgy <br />According to C.R.S. 3~-32-'1 i6(3)(a), each year-, on the anniversary date of the penrrit, au <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding yeaz, new <br />disturbances that aze anticipated to occur during the upcoming yeaz, reclamation that will be <br />performed during the coming yeaz, the dates For the beginning of active operations, and the date <br />active operations ceased for the yeaz, if any. <br />Please attach your revised annual report map and written report to this <br />annnal report. Please note that an adequately Inhered map that clearh~ delineates and <br />includes the above elements nary suffice for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact N((a~~me:,,L-1lnUlLl. ~~1 (.X.l.ll~tn~ ~ Company: (_,CI~/ l ty,! cSt~ ~p~lX U~,i~ <br />Address: `K> ~~X/ ~t!Ony /~p~rq Phone No.: ( ! ~9) ~~~,~p~-a~~7 <br />~N'~l~]Tl'~1~ ~~C.l\U/ FaxNo.:(rIIQ1CX~~'~~~~ <br />h` there aze additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it to [his report form along with your map and/or <br />written report. <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />