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J <br />~ III Illllllllllllill <br />ANNUAL REPORT <br />PERMITTEE NAME: Clyde and Marie Couch <br />PERMIT NO.: M-89-023 <br />OPERATION NAME: Caliche School Pit <br />ANNIVERSARY DATE: March 09, 1999 <br />~ ~~ <br />~~ f~J~ <br />`'V \J <br />V ~ <br />~E1VED <br />,~ ~ ~~ ." u <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00„,-,e,a~5 g geology <br />COUNTY: Logan <br />In order to ensure that our records are up to date, please attach your revised annual report map and written <br />report to this annual report. Note that a written report is not necessary if the map addresses all the <br />items listed in the attached instructions concerning mining disturbance and reclamation update. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: ~l>,I~-~~ r~~. ~ Fs Company: <br />Address::~9S~ (o K~,~ ~ 3u Phone No.: ( ) <br />~jf 2" ~ ,vwT (fin `~-~ ~ Fax No.:~_ ) <br />Comments:: <br />~~~~~ <br />Signature of ~..orporate Officer, or Owner <br />~ yq <br />Date <br />M'1DNRM LWiA5TER1)N7-AF-01. <br />