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~ III IIIIIIIIIIIII III <br />ANNUAL REPORT <br />PERMITTED NAME: San Miguel County <br />PERMIT NO.: M-89-030 <br />OPERATION NAME: Zadra Pit* <br />ANNIVERSARY DATE: May I5, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: San Miguel <br />MPS ,~~ 19&Gec,', <br />tM`~t~ <br />o~~`~°n~ <br />In order to ensure that our records are up to date, please attach your revised annual report man and written <br />report to this annual report. Note that a written report is not necessar~if the map addresses all the <br />items listed iin the attached instructions concerning mining disturbance and reclamation update. <br />Please type or print [he current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: Mike Horner <br />Address::- ro Rnx 42fi <br />Norwood, CO 81423 <br />Company: San MiAUel County <br />Phone No.: ( o7p L327~~835 <br />Fax No.: ( 970 X327-4090 <br />No activity has occurred since last report. <br />Conmrents:: <br /><~ ~~t~-cam S %3 y <br />Signature of Corporate Officer, or Owner Date <br />/NSTR UCTIONS ON BACK <br />~ ~~~ <br />Q~ 62S//Z <br />M.~DNRMLU7ASTERDU7 AF-04 <br />