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<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 />American Soda, L.L.P. <br />M-1999-002 <br />Yankee Gulch Minerals Project <br />July 13, 2002 <br />RECE!\fE® <br />JUL 1 5 2002 <br />Division of Minerals and Geology <br />$1,000.00 (Due on or before your anniversary date) <br />Rio Blanco <br />According to C.R.S. 34-32.5-116 or C.R.S. 3432-116, each yeaz, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of cutren[ disturbances to affected <br />land, reclamation accomplished to date and during the preceding yeaz, new disturbances that aze anticipated to <br />occur during the upcoming yeaz, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the yeaz, if any. <br />Please attach vour revised written annual report and annual report 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 <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pernvttee Contact: Kurt R. Nielsen <br />Permittee Name: American Soda, L.L.P. <br />Address: 2717 CR 215 <br />Parachute, CO 81635 <br />Phone Number: (970) 285-6500 <br />Fax Number: (970) 285-6393 <br /> <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 aze <br />enclosed. <br />ignature of Corporal er or O per <br />Dat~~~~ <br />M:~PERMITNIASTERDOCUMEMS/M-AF-02.DOC <br />