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<br />r• III IIIIIIIIIIIII III <br />ANNUAL REPORT <br />*~ <br />PERMITTEE NAME: Ted R. Hubbs Family Estate <br />PERMIT 1`fO.: M87088 ~.~CE~VE~ <br />OPERATION NAME: Hubbs Pit r• t .j 1S99 <br />eta ~, <br />ANNIVERSARY DATE: July 14, 1999 6Gealogy <br />~;viswn of Minerals <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: 550 <br />COUNTY: La Plata 1 <br />According to C.R.S. 34-32-116(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 [o occur during [he upcoming year, reclamation [hat will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the <br />year, if any. <br />Please attach your revised annual report maa and written resort to this annual resort. Please <br />note that nn adequately labeled mnp tlurt clearly delinenies and includes the above elements mny <br />suffice for n written report. <br />Please type or print the current contact person's name, mailing address. and phone number in the space <br />provided: <br />ContactName: Bar~Oara i-Ic~b~s <br />Ad~dre-s-s:Z'jr-/(~ ~~d p,~,>,~.. fZt~ <br />Company:7C~ ~ /~wbbs ~a~: ~y 1P45~ <br />Phone No.: (S~b) (o G a - (o a 0 ~ <br />Fax No.: (S'~0) (7q ~ - ~"I I S- <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 [o this report form along with your map and/or written <br />report. <br />:`~~'`~~ <br />/~-mod-~y <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />