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-iii iiiiiiii~iiuiii <br />999 <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEENAME: DGMC RECEIVED <br />PERMIT NO.: M-1986-076 DEC 3 1 2001 <br />OPERATION NAME: Incas Mine Division of Minerals and Geology <br />ANNIVERSARY DATE: December 31, 2001 <br />ANNUAL FEE DUE: $450.00 (Due on or before your anniversary date) <br />COUNTY: La Plata <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, 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 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 yeaz, if any. <br />Please attach your revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Perntittee Contact: Robert W. Hill <br />Pettnittee Name: DGMC <br />Address: P.O. Box 9fi <br />Hesperus, CO 81326 <br />Phone Number: (970) 946-3331 <br />Fax Number: <br />h` 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 />enclosed. <br />Q w,~~~ <br />Signature of Corporate Officer or Owner <br />t 2 i.~ o <br />Date <br />M:~PERMm V.7 ASTERDOCUM ENrS/Af ~AF-0?.DOC <br />