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RECEIVED <br />PERMITTEE NAME: <br />San Miguel County <br />NOV 0 62002 <br />PERMIT NO.: ~ M-1981-154 <br />OPERATION NAME: ~ Norwood Pit <br />ANNIVERSARY DATE: November 20, 2002 <br />Division of Minerals end GeoloAY <br />ANNUAL FEE DiIE: $688.00 (Due on or before your anniversary date) <br />COUNTY: San Miguel <br />According to C.R.S..'.4-3Y.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit; an <br />ogorato: shall submi;~the annual fee, a report_and.map showing the_extent_of Curren[ disturbances to affected <br />]and, reclamation aEcomplished to date and during the preceding yeaz, new disturbances that aze anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the yeaz, if any. <br />Please attach vour revised written annual resort and annual report man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following petnvttee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mike Horner <br />Pernvttee Name: San Miguel County <br />Address: P.O. Box 426 <br />Norwood, CO 81423 <br />Phone Number: (970) 327-4835 <br />Fax Number: (970) 327-4090 <br />L` you have additions] comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instmctions are <br />enclosed. <br />tgnatu~ otpomtl~r, Owner, or Designee <br />~~ ~' ~!~ <br />Date <br />M:{PFRM7nMASiERDOCV MEMS~M~AF-04 <br />