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~/~ <br />'cF~ ~rl ATi Drium u~nrrcrrll 111 luJ LS ~ V ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />/Mineral County <br />~i I-1984-097 <br />Mineral County Pit <br />Juue 28, 2007 <br />MAY 1 4 2001 <br />MINERAL COUNTY E~ <br />$$688.00 (Due on or before your anniversary date) <br />Mineral <br />_ =_-_According,to C.R.S. 34-32.5_116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map sTiowing tF-ie extent of cuirerit disturbances-to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual resort and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new chances to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Leslie Cahill <br />Permittee Name: Mineral County <br />Address: P.O. Box 70 <br />Phone Number: <br />Fax Number: <br />Creede, CO 81130 <br />(719)658-2360 <br />(719) 658-2931 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclo-~L G~..~ <br />Signature of Corporate Officer, Owner, or Designee <br />~~ %~ .200 <br />Date <br />~~cF®VF <br />~' "~~'w; <br />M:~PERMTTNIASTERDOCUMEMS~M-AF-04 <br />