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~,~~~ <br />~% <br />JAN Z 9 200 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Bumgarner Ranches <br />M-1980-027 <br />Brig Pit <br />February 2, 2004 <br />$281,00 (Due on or before your anniversary date) <br />Grand <br />Division of Minerals and Ceolagy <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 operator <br />shalt submit -the annual-fee,-a report and-rnap showing- the-extent-oi current distcu~bances to-affected-land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming yeaz, reclamation that will be performed during the coming yeaz, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anm~al rennrM and anm~al red nrt maT to }his fnrm_ Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact informatien. Please verify and make any necessary <br />changes: <br />Penrrittee Contact: Gary Bumgarner <br />Permittee Name: Bumgarner Ranches <br />Address: P. O. Box 186 <br />ICremmling, CO 80459 <br />Phone Number: (970) 724-9224 <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 map. Annual Report instructions are enclosed. <br />Si re of S' orate Officer, Owner, or Designee <br />1-~7-t?y <br />Date <br />M:~PERMITMASTERDOCUMEN'ISVvt-AF-01 <br />