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~. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />M Peter Schrepfer <br />M-1994-006 <br />Emerald Vista Estate <br />March 11, 2003 <br />$281.00 (Due on or before your anniversary date) <br />Las Animas <br />RECEIVED <br />FEB 2 012003 <br />Division of Minerals and Geology <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 />shall submit the annual fee, a -report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the 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 the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Phase attar,~,ym>tr revised written anm>lal re~nrt and anmlal report ma= in this Sorm_ Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Frank Leone, Jr. <br />Permittee Name: M Peter Schrepfer _~~~ %.~~o r adg-T `or-1 i` S ~~ r~«'r~ <br />Address: 502 S. Walnut <br />Trinidad, CO 81082 <br />-- Phone Number:. (71_9) 846_-4170 _ _ _ <br />Fax Number: (719) 845-0605 <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />r ~' <br />Signature of Corporate facer, Owner, or Designee <br />~. ~' Icy 0 3 <br />Date <br />M:IPERM ITNIASTERDOCUMENTSU4-AF-01 <br />cJ•~ ,e ~u'>'e avt g>~ <br /> <br />