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<br /> ANNIiAi, FRF. and RF.Pn RT RF.nIiF.ST <br />RECEIVED <br />PERMITTEE NAME: Park County <br />PERMIT NO.: M-1980-019 APR 0 9 2003 <br />OPERATION NAME: Hall Gulch Pit Oiuision of Minerals and Geolosy <br />ANNIVERSARY DATE: April 1, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Park <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />-operator shall submit the-annual-fee;-a-report-and-map-showing-the-extent-of-current-disturbances to affected-- <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anneal report and anneal report main to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Robert Vance <br />Permittee Name: <br />Address: <br />Park County <br />P.O. Box ] 47 <br />Fairplay, CO 80440 <br />Phone Number: (719) 836-4283 <br />Fax Number: (719) 836-4275 <br />F~t)C~ ~~ITN- <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of o ora e Officer, Owner, or Designee ~~ ~~ <br />~ ~1~ <br />Date <br />M:~PERM ITUAASTERDOCUM ENTSNI-AF-04 <br />