2002-11-27_REPORT - M1977568

• Permit No: M1977568
• IBM Index Class Name: Report
• Doc Date: 11/27/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Saguache County
M-1977-568
Cooper Pit
November 25, 2002
$688.00 (Due on or before your anniversary date)
Saguache
RECEIVED
NOV 2 72002
Division of Minerals and Geology
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-ll6, each year, on the anniversary date of the permit, an
_ operator shall submit the annual fee a~oort and man ~hn rhP PvrP..r „t' ~istatybences-te_af{'ected -
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during [he upcoming year, reclamation that will be performed during [he coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report man to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: ,TtihtrY-tfrrgefng
Permittee Name: Saguache County
Address: P.O. Box 476
Saguache, CO 81149
Phone Number: [phone]
Fax Number: [phone]
~ N w l l~l rslao6e~ ~
If you have additional comments andlor information that should be provided to [he Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
ignatu of Corporate Officer, vne ~ o ignee
Lr 12~ ~~~
Date
M:NERMn VNASTERDOCUM ENTSN9-AF-04