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• • iii iiiiiiiiiiiiiiii <br />99 <br />PERMITTEE NAME: John E. Bowman <br />PERMIT NO.: M-79-192 <br />OPERATION NAME: Spotted Burro Pit <br />ANNNERSARY DATE: October 14, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Fremont <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit 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 yeaz, 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 <br />annual report. Please mote that tut adegrurtely labeled rnnp thnt clearly delineates and <br />includes the nbove elements mny suffice for n 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 <br />Company: <br />Phone No.: <br />Fax <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 />Signature of Corporate Officer, or Owner <br />Date <br />INSTRUCT/ONS ON BACK <br />