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~ ~ III IIIIIIIIIIIIIIII <br />k <br />ANNUAL REPORT <br />PERMITTEE NAME: Tezak Stone & Aggr Supply Inc <br />PERMIT NO.: M-81-080 <br />OPERATION NAME: Tezak No 2 Pit <br />ANNIVERSARY DATE: May 27, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Fremont <br />_CEIVED <br />MAY 2 6 1999 <br />~~ ~~ <br />~~ <br />~~ ~~~ <br />,~ Minerals & Geology <br />In order to ensure that our records are up to date, please attacn yvu~ ..,.:.,, a _~_...~ __r.,.~ ,~,at, ~~u ...,.,.... - <br />report to this annual report. Note that a written report is not necessary if the map addresses all the <br />items listed in the attached instructions concerning mining disturbance and reclamation update. <br />Please type or print [he current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contac[Name: M-ke- TZ'AK Com an T Zr9K S~'~` ~/9~~~?a~~ s~~y <br />P Y~ - v <br />Add~re'ss:: ~,',ZOD (',o~.rtf y RD. 3 7 Phone No.: (7/ `~l a-7S - ~/ y4 <br />j ~?(/4S Gittc,~ Co Fax No.: (71 ~I 1 o27s~ l / ~7'tlC <br />$/2~3 l <br />.~t,D ~ ,, s- aS- 9. <br />Signature of Corporate O tcer, or Owner Date <br />INSTRUCT/ONS ON BACK <br />M:~DNRMIl.UIHSTERDUI-AF-01. <br />