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<br />• ~iiiiiiiiiiiuiiiiii ~ <br />999 <br />ANNUAL xr;ruxl <br />PERMITTEE NAME: Kit Carson County <br />PERMIT NO.: M-91-069 <br />OPERATION NAME: Heintges Pit* <br />~Fc <br />oy~o /Gyo ~~`F4 <br />no~~~ 87999 <br />5 <br />~C~~~ <br />ANNNERSARY DATE: July 10, 1999 ~ ~ ~ ' <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 \ <br />Er:e. ':~ i r <br />COUNTY: Cheyenne <br />According to C.R.S. 34-32=116(3)(x),-each year,-on"the annivers"ary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />[o 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 mote drat nn adequntely labeler! mup lhnt clearly rlelinenres raid <br />includes the nbove elements nrny s~effice}or 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 Name: (iL L~Ll ~(ZA>,7V1t1 ~CX <br />Address: pd ~rtr5~ llnO <br />~3(lrl~~.a~on ~ 8~8b7 <br />Company: <br />Phone No.: ( ~ lQ) 3~Cn- 8'l~9 <br />Fax No.: ('Z l 9) 3 ~' G - `~ of ~' ~ <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 fornt along with your map and/or <br />written report. <br />a~.J ,~, .~~....~-~1 <br />Signature of Corporate Officer, or Owner <br />`-/-~9 <br />Date <br />INSTRUCT/ONS ON BACK <br />