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SEP-�4-2001 MON 08:44 AM FROM: III IIIIIIIIIIIIIIIIII III FAX: PAGE 3 <br /> sss <br /> ANNUAL FEE and REPORT REOUEk RECEIVED <br /> SEP 2 8 2001 <br /> PERMITTEE NAME: Mine Development, Inc. Division of Minerals and Geology <br /> PERMIT NO.: M•1981-165 <br /> OPERATION NAME: Neglected Mine <br /> ANNIVERSARY DATE: October 2,2001 <br /> ANNUAL FEE DUE: $225.00(Due on or before your ann ers ry date) <br /> COUNTY: La Plata <br /> According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the ni ersary date of the permit, an <br /> operator shall submit the annual fee, a report and map showing the extent f c sent disturbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new list <br /> antes that are anticipated to <br /> occur during the upcoming year.. reclamation that will be performed during the omung year, the dates for the <br /> beginning of active operations,and the date active operations ceased for the ear . any. <br /> Please attach Your revised written annual report and annual report m to is form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above em is may suffice for a written <br /> report, <br /> Division records indicate the following permittee contact information. Pl se rify and make any necessary <br /> changes: <br /> Perm ittee Contact: Harold E.Luzar <br /> Permittee Name: Mine Development,Inc. <br /> Address: 3319 E.4th Ave. <br /> Dumango, CO 81301 <br /> Phone Number: (970) 247-1652 <br /> Fax Number: (281) 578-3159 <br /> If you have additional comments and/or information that should be provido to he Division, please provide it <br /> below or attach it to this form along with your written report and mal A inual Report instructions are <br /> enclosed. <br /> 5 �'. <br /> Signature of C rporate Officer or Owner <br /> 5-2-Y-0I <br /> Dare <br /> M;1pERMITMASTERDOCUMENTS/M-AF-M DO(: <br />