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<br />r,,:.. <br />R~~~IVE~ <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Joseph L. and Arlene Cogan <br />M-1998-091 <br />Arnold Gulch <br />February 19,2005 <br />FEB07~ <br />Divisiono/Mine~als~and Geology <br />$281.00 (Due on or before your anniversary date) <br />Chaffee <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-1 ib, each year, on the anniversary date of the permit, an operator <br />__ , shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new ~stur antes that are an ictpated fo occur-- <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach xDnr revised written anneal rennrt and anneal res nrt mad to this form. Please note that an <br />adequately labeled map that clearly delineates and includes [he above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joseph L. Cogan <br />Permittee Name: Joseph L. and Arlene Cogan <br />Address: P.O. Box 113 <br />Nathrop, CO 81236 <br />Phone Number: (719) 395-2339 <br />Fax Number: <br />wL .~~~ <br />~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 enclosed. <br />v~ <br />Signa ur of Corporal Officer, Owner, or Designee <br />;l '..eg r <br />7' b ~ <br />Date <br />