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,.,_ ..,: r.. <br />., <br /> ANNfiAf, FF.F, and RF.P(1RT RF.n fIF.CT <br />RECEBVEp <br />PERMITTEE NAME: $aca County <br />PERMIT NO.: M-1977-479 AUG 2 g 2003 <br />OPERATION NAME: Walsh Pit No. 2 Division ~f Minerals and Geolo <br /> gy <br />ANNIVERSARY DATE: September 11, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Baca <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 />_ operatorshall_submiT_the.annual.fee,_a report.and_map_showing.the_extent_o£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 xgnr revised written annnal rennrt and annnal re nn rf m~ to this form. Please notC that an <br />adequately labeled map that clearly delineates and includes the above elements may suffce 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: Commissioner Ray Miller <br />Permittee Name: Baca County <br />Address: 741 Main St. <br />1 <br />Springfield, CO 81073 `~ <br />Phone Number: (719) 523-6532 <br />Fax Number: (719) 523-6584 ~' <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 />~~~ <br />Signa e of Corporate Officer, Owner, or Designee <br />Date <br />M:~PERMITMASTERD000MENTSNd-AF-04 <br />