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L <br />J III III I I III <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Frank W Hewes <br />M-1978-314 <br />Hewes Pit <br />November 22, 2001 <br />$281.00 (Due on or before your anniversary date) <br />Routt <br />~~U 2 9 Z~~7 <br />Division of Minerals and Geology <br />According to C.R.S. 34-32.5-1 16 or C.R.S. 34-32-116, each year, on the anniversary date of [he permit, an operator <br />shall submit the annual fee, a- report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished [o date and during [he preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for [he beginning <br />of active operations, and [he date active operations ceased for the year, if any. <br />Please attach your revised written annual reuort and annual report map to this form. Please store thnr mt <br />ndequately labeled mnp that clearly delineates and includes the above elements Wray since for a written report. <br />Division records indicate the following permit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Nathan W. Hewes <br />Permiuee Name: Frank W Hewes <br />Address: C/O Hewes & Hewes, lnc. <br />Box E <br />Toponas, CO 80479 <br />Phone Number: (970) 638-4644 <br />Fax Number: <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 Inap. Annual Report instructions are enclosed. <br />/~~~~ <br />Signature of Corporate Officer or Owner <br />1/-/q- al <br />Date <br />M:IPERM ITh7A5TERD000MENTSWf-AF~01 <br />