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~~ <br />~ III IIIIIIIIIIIII III ~ ~,~ ~P~ <br />`~~~p~~~ <br />ANNUAL REPORT /~~ / <br />RECEIVED <br />PERMTI'TEE NAME: Park County ,~ <br />PERMIT NO.: M-80-251 '~n~s 2 4 ~S°9 <br />Division of Minerals & Geolo <br />OPERATION NAME: Ansley Flat Pit* By <br />ANNIVERSARY DATE: April 01,1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Park <br />)n order to ensure that our records are up to date, please attach your revised annual report map and written <br />report to this annual report. Note that a written report is not necessary if the map addresses all the <br />items listed in the attached instructions concernin>; mining disturbance and reclamation update. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: /IOQE/QT {/i~ING G <br />Company: PhRKCoc.~ITY RnAO f.QRIOGF <br />Park County Fioa~d 8 Bdi~e <br />Address:: BOx 147 <br />1248 Counl~r ROwdM/1d <br />-~.-~ ~~ <br />rim/e~ ~~~rc{~'o.~c S ~!///SDf ~or r~St~ <br />Signature of Corporate Officer, or Owner <br />Phone No.: (7~ 9) S 3 6- H 2 8 3 <br />Fax No.: ( 7/ 9') 83 6 - 't/ 2 7J <br />Date <br />h1dDNRMLN1 ASTERDU7-A F-OJ. <br />