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~ III IIIIIIIIIIIII III <br />ANNUAL REPORT <br />PERMITTEE NAME: Prowers County <br />PERMIT NO.: M-77-387 <br />OPERATION NAME: Bates Pit <br />ANNNERSARY DATE: December Ol, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Prowers <br />• ~ ~ r ^^ <br />~~ ~ ~ <br />~FCF~VFD <br />othsto ~~V 2 9 1899 <br />nat M~~~h6 Gep <br />~Y <br />According to C.R.S. 34-32.5-116(3)(a), 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 <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 vour revised annual report map and written report to this annual report. Please <br />note that an adequately labeled map that clearly delineates and includes the above elements nuq~ <br />suffice 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 />Con[ac[ Name: DONALD KOEHN Company: PROWERS COUNTY <br />Adddress: 109 E. SHERMAN ST. Phone No. : (719) 336-5536 <br /> LAMAR, CO 81052 Fax No.: ( 719) 336-9633 <br />If there are additional comments and/or information [hat 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 />~~ <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />