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r~ <br />N <br />. ~J <br />RECEIVE® <br />PERMITTEE NAME: Washington County AUG 1 1 2004 <br />PERMIT NO.: M-2000-084 <br />Division of Minerah+& Geology <br />OPERATION NAME: Chris Aaegeson Pit #2 <br />ANNIVERSARY DATE: August 30, 2004 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Washington <br />According to C.R.S: "34-32:5=116 or C:R.S. 34-32-116; each year, on the anniversary-date of the permit,- ari '" <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land,_rcclamatinn_accnmplished_to_date_and_during_the_preceding_yaar, newslisturbances_that_are.anticipated_to___ <br />occur during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written annual re,Pnrt and annnal re~nrt main, to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Charles J. Kuntz ~i ~ Z/i,,.~) ~L_ u_.y iL~yww~~ <br />Permittee Name: Washington County o~ ~, <br />Address: 150 Ash QQ ~a <br />+r <br />~ <br />ZJ l~ ~/[~ ~.,~p. <br /> Akron, CO 80720 ~~,w ~~ <br />~ <br />, <br />l_ ~~ ~as.,~FVyt/ <br />i~-- <br />Phone Number: (970) 246-3347 ~~ p n // ~~ <br />~ i ~ ~Le.~ <br />~ <br />' <br />Fax Number: (970) 345-2702 p <br />y <br />~.r-~~,~i <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 />enclosed. <br />~~~,~. <br />Signature of Corp rate Offic caner, or Designee <br />~'-9- a ~ <br />Date ~ <br />M:~PERMI7IMASTERDOCUMEMSNI-AF-04 <br />