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• • • Ill IIIIIIIIIIIIIIII o <br /> ANNUAL REPORT 9FC�✓ <br /> 4- FO c: a 8 Geology <br /> PERMITTEE NAME: Lance and Bob Barker °*o�tt <br /> PERMIT NO.: M-77-417 rd JaGO,,, <br /> '•boy <br /> OPERATION NAME: Sego Mine <br /> ANNIVERSARY DATE: November 01, 1999 <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 PAID <br /> COUNTY: San Miguel <br /> According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an operator shall <br /> 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 disturbances that are anticipated <br /> to occur during the upcoming year, reclamation that will be performed during the coming year, the <br /> dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br /> Please attach your revised annual report map and written report to this annual <br /> report. Please note that an adequately labeled map that clearly delineates and includes the above <br /> elements ntay sake for a written 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: Company: <br /> Adddress: Phone No.: <br /> City, State ZIP Fax No.: <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 /> l <br /> -z - <br /> Signature of Corporate Officer, or Owner Date <br /> INSTRUCTIONS ON BACK <br />