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~~ <br />PERMITTEE NAME: John Dillon <br />PERMIT NO.: M-86-165 <br />OPERATION NAME: Willow Bend <br />III IIIIIIIIIIIIIIII <br />ANNUAL REPORT <br />ANNIVERSARY DATE: August 27, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: La Plata <br />i <br />® '. <br />, <br />CEIVED <br />AU(~ 2 3 1999 <br />~:4~~.~,~ „i Inineray ~ Geo1o9Y <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the pe it, an <br />operator shall submit t'ne annual fee, a report and map showing the extent of curve t 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 t at will be <br />performed during the coming year, the dates for the beginning of active operation and the date <br />active operations ceased for the year, if any. <br />annual Peport. Please note that an adequately labeled rnap t/tar clearly delineates and <br />includes tke above elements may suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phon~ number in the <br />space provided: j <br />Contact Name:~n C'LVl l C~~ ~ 1 1 fj~ Company: <br />Address: P O 'l' (1 ~ y y ~ ~ Phone No.: <br />la t`Q dl G Z~ ~ ~ Fax No.: ) 3 a - <br />~ 130 ~ <br />If there are additional comments and/or information that should be provided to the~Division, <br />please provide it on a sepazate sheet and attach it to this report form along with yo r map and/or <br />written report. <br />~ 1~ 99 <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />