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ANNUAL REPORT <br />PERMITTEE NAME: John O Buckner <br />PERMIT NO.: M-1993-030 <br />OPERATION NAME: Crystaljack Mine <br />ANNIVERSARY DATE: Apri126, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $75.00 <br />COUNTY: Teller <br />P~111 <br />F-ii=1r~! V>=~ <br />APR 0 5 2000 <br />^is~on of Mirera~e 8 t9zn~oy <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach vour revised annual report map and written report to this annual report. <br />Please ante that rm adequately labeled map that clearly delineates and includes the above <br />elements may suffice jor a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: John 0. Buckner Company: Crystal jack <br />Address: 2516 Waldean St. Phone No.: ( 719 1 634-4042 <br />Colorado Springs, CG 80909-4015 FAXNo.:( 719) 634-5431 <br />[f there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />a <br />Si azure of rate Officer, or Owner Da <br />INSTRUCTIONS ON BACK <br />\ M:~PERMfIV.f ASTERDOCUMENTS/M-AF-O? DOC <br />