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!' <br /> <br />~II II~I~~II~II~~ II~ <br />sss <br />ANNUAL REPORT <br />PERMITTEE NAME: Phillips County <br />PERMIT NO.: M-1986-047 <br />OPERATION NAME: Austin Pit <br />ANNIVERSARY DATE: May 5, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Phillips <br />U <br />1'101 <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall subtni[ the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, 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 annual resort. <br />Pleuse mote that an ndeguately labeled map drat clearly delitreutes and includes the above <br />elements may suffice 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: Randy Schafer Company: Phillips County <br />Address: ~~t S_ TnharnrP~ Phone No.: (g~~ 1 g~3Z~8 <br />Holyoke, CO 80734 FAX No.: (970 ) 854-3811 <br />If there are 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 />~~f ~~~~~ ~/i7/o a <br />Signatur f Corpora Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />Ai.WERTII-Mi gSTERUUCUAf ENTSNI-AR0.1 <br />