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III IIIIIIIIIIIIIIII <br /> 99 <br /> ANNUAL REPORT �FCEIVED <br /> NOV 15 1ggq <br /> PERMITTEE NAME: Persolite Products Inc minerals&Geology <br /> PERMIT NO.: M-77-319 <br /> OPERATION NAME: Swallow Perlite Mine <br /> ANNIVERSARY DATE: November 22, 1999 ra <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br /> COUNTY: Custer <br /> According to C.R.S. 34-32-1 16(3)(a), each year, on the anniversary date of the permit, an operator shall <br /> submit the annual fee, a report 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 <br /> to occur during the upcoming year, reclamation that will be performed during the coming year, the <br /> dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br /> Please attach your revised annual report map and written report to this annual <br /> report. Please note that an adequately labeled snap that clearly delineates and includes the above <br /> elements may suffice for a written report. <br /> Please type or print the current contact person's name, mailing address, and phone number in the space <br /> provided: <br /> Contact Name: Mjii 44At_L `, 67�wEp Company: ?ERSOLiTE PROD., MAX, <br /> Adddress: P.D. Box Soy Phone No.: ( ILq ) 79y-C S 3( <br /> City, State ZIP rl 1)'2t`nJEe CO. RlZ?,6 Fax No.: (719 ) 79`/- SiBSS- <br /> If there are additional comments and/or information that should be provided to the Division, please <br /> provide it on a separate sheet and attach it to this report form along with your map and/or written <br /> report. <br /> Signature of Corp to Officer, or Owner Date <br /> INSTRUCTIONS ON BACK <br />