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s~~+~' <br />•~ Ll ~ <br /> ANNIIAI. FF.F. anti REPORT REOI'EST <br /> L' <br /> RECFwF~ <br />P1iRMITTF,ii NAME: Louis ht. Wyman ~ AUG 2 S 2006 <br />PHRMI'f NO.: [- h1-1983-037 <br /> <br />UPiRATION NAMi?: <br />N'vman Plt r l)iVr.~un ~~ ~ i.in..r ~. ~,. <br />r.,, <br />ANNIVi.~RS.ARY I)A'ffi: May 31, 2DOE <br />ANNItAI. flip: I)l:l~, 5281.00 (Uuc on or before your annh•cnan date) <br />COl IN'I'Y": Routt <br />According to ('.R.S. 34-32.5-I 16 or C.R.S. 34-32-I IG, cuch year, at the anniversary date ol'the pcrnnt, an uperauu <br />s}udl submit the :umual fee, a rclxtrt and nutp showing the c~tent of current disturbances to offccted land, <br />rcclunwuon accomplished to dolt and dunng the preceding year, new dtsturbances that arc anticipated to occur <br />during flit upcoming year, reclamation that w01 lx performed dunng the coming year, the dates for the bcgmmng <br />of active opcmtions, and the Jatc active operations ceased Yor flit year, if any. <br />Plrrar attarh ym~r rrvlaed wrlttrn annual reranrl and annual rennrt ttt~n to thfa fnrtn. please note that an <br />adequately luheled mop that clearly delineates ant! includes the abotK elements mqt• ruOic r_/irr n written report. <br />bivision records induate the following permn)ee contact information. Please venfy and nwkc uny necessary <br />changrs: <br />Pcvmittec Contract: (.. M. Wyman ~~y„~•I {r~.e / <br />Permtttcc Namc: Lows M. Wyman -ke U.e~-tx 4_.• ~~f• ~e<~j <br />Address; P.O. F)ox 278 ~ ~ , <br />Creig, CO 81626 <br />Phone Numixv: (703) 824-G431 <br />Fnx Number: <br />If you have addihonul comntcrtts and,'or information that should be provided to the Division, please provide it <br />lxlow or attach it to this form along with your wnttrn report and map. Annual Krpon mstrucpons are encloseJ. <br />fib c.+-~----~ '' ' l ~l~ • t .~..y.., <br />Signature of C'orponttc Officer, Owner, Drsignee <br />~~lr <br />