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iii iiiiiiiiiiiu iii , ~----, <br />r ~~~ <br />t ,.,,, <br />ANNUAL REPORT <br />RECEIVED <br />PERMITTEE NAME: Sand Creek Farms Inc <br />PERMIT NO.: M-92-038 <br />OPERATION NAME: Sand Creek Mine <br />ANNIVERSARY DATE: September Ol, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Adatns <br />S1=P 0 3 1999 <br />Division of Minerals & ~eologY <br />According to C.R.S. 34-32-116(3)(a), each year, on [he anniversary date of the permit, an <br />operator shall submit the annual fee,,-a repo: and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding yeaz, new <br />disturbances that aze anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming yeaz, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual reAOrt. Please note that ar: adequately labeled map that clearly deli~ieates and <br />inchedes the above elements mny since for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name:~,~ ~P~` <br />Address: ~ 4ay <br />y.e~S l art A.b g12~ <br />If there aze additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />Signature of C or to Of cer, or Owner Date <br />Company: Si~~D ~firz~e~(' Lc,rr.~S' <br />Phone No.: (~°/') ~ R 2 9'Y ~~ <br />Fax No.: G3o3 ) ~ 2,-2 f5'-5--3 <br />INSTRUCTIONS ON BACK <br />