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~. <br />IIIIIIIIIIIIIIIIIII ~ RECEIVED <br />sss t ; , ~ ~ 1CS~ <br />ANNUAL REPORT <br />Division of Minerals & Geology <br />PERMITTEE NAME: Kit Carson County <br />PERMIT NO.: M-82-189 ~ ~ ~~ <br />OPERATION NAME: Hornung Pit ~~ <br />ANNIVERSARY DATE: October 28, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Kit Carson <br />According to C.R.S. 34-32-I 16(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 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 <br />annual report. Plense note dint nn adequntely labeled map that clearly delineates and <br />inelurles tAe above 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 />ContactN((,~a~me:~nC~O ~~-~.,1~ <br />Address ,'I~1~Q~ <br />Company,f<~ l~~c (}~ l",~41,~y <br />Phone No.: (~ ~ q) 3y(~-8(39' <br />Fax No.: ( 7r 9) 3~1~ - t7~4a <br />L` 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 Date <br />INSTRUCTIONS ON BACK <br />