REP20817

• Permit No: M1998052
• IBM Index Class Name: Report
• Doc Date: 7/14/2003
• Doc Name: Annual Fee/Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rock Island Land Co., LLC
M-1998-052
Rock Island Operation
July 22, 2003
JUL 14 Z(103
4ivlelon ~f Minerals and Geology
$281.00 (Due on or before your anniversary date)
Summit
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
---reclamation-accomplished to date and during the preceding year, new disturbances that are anticipated to occur - _
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach xQJrr revised written annual rem rt and annual refit maT to thin form. Please note that an
adequately labeled map that clearly delineates and includes tJre above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Sam McCleneghan
Permittee Name: Rock Island Land Co., LLC
Address: P.O. Box 1012
Breckenridge, CO 80424
Phone Number: [phone]
Fax Number: {970) 453-6395
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.

of
Date
Owner, or Designee
M:~PERMITN1A57ERD000MEN7SVvi-AF-01