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<br /> <br />ANNUAL FEE and REPORT REQUEST <br /> <br />RECEIVED <br />SEP 1 1 2002 <br />PERMI'I1'EE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Oaklands Ranch <br />M-1989.092 <br />Oaklands Ranch <br />October 26,2002 <br />$281.00 (Due on or before your anniversary date) <br />Douglas <br />Division of Minerals and Geology <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />_ - ~>shall_submit=therannual_fee,: a report_and map. showing- the ant-of-current disturbances_to affected-land,-- - <br />reclamation accomplished to date and durin¢ the~cedinQ year, new disturbances. that are anticipated to occur <br />durin the ear, reclamati n that will be erformed during the coming year, the dates <br />of active operations, and the date active operations ceased for the year, t any. <br />Please attach vour revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the Following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David Curtis <br />Permittee Name: Oaklands Ranch <br />Address: 1613 N. Perry Park Rd. <br />Sedalia, CO 80135-8511 <br />Phone Number: (303) 688-4285 / --+~ <br />- - ---Fax-Number:' - ----__ _ _ _ - -~=--`°-°--°~=Zrj-S -~- `/ ~S / - -_ = <br />If you have additional 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 instructions are enclosed. <br />~i ~~u~~C l~s`e~ <br />Signature o Corporate Officer, Owner, or Designee <br />-D2 <br />Date <br />M:~PERMnN-0ASTERD000MENTSVN-AF-01 <br />