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ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />So. Way Co. <br />M-1984.025 <br />Stage Stop Pit <br />July 26, 2002 <br />JUL 1 0 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Saguache <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-tkie-annual-fee;-a-reper3- and-map-showing-the- extent-of-current-disturbances to- affected land,--- <br />reclamation accomplished to date and during the preceding year, new disturbances that 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 vour revised written annual resort and annual resort mau 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: Rock I. Southway <br />Permittee Name: <br />Address: <br />So. Way Co. <br />117 White Pine Dr. <br />Alamosa, CO 81101 <br />Phone Number: (719) 5$9-5103 <br />Fax Number: (719) 589-5522 <br />If you have additional comments and/or information that should be 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 />Signature of Corporate Officer o Owner <br />7 <br />Date <br />M ~PERMI7\MASTERDOCUMENTSVvI-AF-OI <br />