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iii iiiniiiniu iii <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 />Bumgarner Ranches <br />M-1980-027 <br />Brig Pit <br />February 2,2002 <br />$281.00 (Due on or before your anniversary date) <br />Grand <br /> <br />RECEIVED <br />JAN 18 ?pp~ <br />Division of Minerals and Geology <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, 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 accomplished to date and dunng the preceding year, new disturbances that are anticipated [o 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 report map to this form. Plense dote t(tnt art <br />ndeyuately labeled ntnp thnt clearly delineates aru! includes the above elements nrny since for n trritten report. <br />Division records indicate [he following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact Gary Bumgamer <br />Permittee Name: Bumgarner Ranches <br />Address: P.O. Box 186 <br />Kremmling, CO 80459 <br />Phone Number: (970) 724-9224 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ to [his form along with your written report and map. Annual Report instructions are enclosed. <br />f-t~_ <br />Si tare of orporate Officer or Owner <br />Q~rt I~O.Z <br />ate <br />A7aPERMITV.7A5TERD000M ENTSN7-AF-01 <br />