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-_ <br />~II ~I~III~I~~~~~~I~ <br />999 <br />Al~r~ vrii. 11c~ryKT <br />PERMITTEE NAME: Bent County <br />PERMIT NO.: M-83-177 <br />OPERATION NAME: Adams Pit <br />ANNIVERSARY DATE: November 02, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Bent <br />p~~9011 <br />~~~~~v~® <br />~p~ 1~ ~9~G~,o9Y <br />~~ytah <br />~~~M <br />According to C.R.S. 34-32.5-116(3)(a), each yeaz, on the anniversary date of the permit, an operator <br />-shall submit the annual fee, a report and map_showing the extent of current disnicbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that cm ndequntely labeled mnp that clearly delineates and includes the above elements may <br />since for n ~rritten report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: v; rt eTR,,,-kt,~i cer <br />Adddress: <br />Las Animas, Co. 81054 <br />Company: Bent County <br />Phone No.:(719) 456-2223 <br />Fax No.: X19 )456-0375 <br />If there aze additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to [his report form along with your map and/or written <br />report. <br />~L/,~~ O~~„ ~ 10/29/99 <br />Signature orporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />