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• iii iinininiii iii • <br />999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Penn Mountain Mining Inc * ~~~ <br />PERMIT NO.: M85022 .;CrG~ ,-'`~ y <br />~eo~o, <br />OPERATION NAME: Bullger Basin Placer y, <br />ANNIVERSARY DATE: May 23, 1999 `: \,\~esa~ <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: 550 <br />COUNTY: Park <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the perm~t, an operator <br />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 <br />anticipated [o occur during the upcoming yeaz, reclamation that will be performed daring the coming <br />year, the dates for the beginning of active operations, and the date active operations deased for the <br />year, if any. <br />Please attach our revised annual re ort ma and written re ort to this annual' a ort. Please <br />note that an ndequntely labeled map that clearly delineates and includes the above a ernents may <br />suffice for a n~ritten report. <br />Please type or print the current contact person's name, mailing address, and phone ndmber in the space <br />provided: <br />Contact Name: Company:~,t~~at ~ MllVil~tl Z~ <br />Address:, ~ $ Z oZ ~i 5"S Phone No.:~D/) y7q^ y~00 <br />t*~a~~~t~9, R4yo3 Fax No.: (fJ0/ )I}7y~I0 <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signatur f Corporate Officer, or Owne Date <br />INSTRUCTIONS ON BACK <br />