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. '! <br />,. <br />I'LK\111 f4:4- V:\\1G: <br />Phk\11I Vt) <br />\NVIVI.Kti:\Kl' UA1li: <br />\NNU:\I. I Lh Iri I.: <br />('Ol'N Il'. <br /> ~r , i <br />('/~ :1\\l :\1. FF:F: and RFI'O I2T KF.OIiFti'1' <br />Baca Cnunh <br />\1-Iy..-J79 <br />N al+h I'it i\u. <br />ticptcmbcr I I.:UUG <br />ti6NR.1111 (Uuc un ar before ~aur:rnnivcrsan Jatcl <br />Racy <br />:\ca+rJing to C.K ~ i.l-i?.~-I I(> ur C.K.ti. ?d-;'_-I 16, each )car. ,+n the anniccrsan Jate of the pennn.:m <br />operator ,hall submit the annuli) Ice, a report and map +hoiiing the e\tent of current Ji,turh:mce; a, aflcctcd <br />Iand. reclamation aceumpli,hrd to Jatc on.l Juring the preceding ~e:u. nr,i di>turh;mce, th:u are anlicip:urd Ir+ <br />,near donne the upronun~ Vicar, rcrlamahon shot ,all t,e lxrli,mud dunng the coming w:u, the J;nes li+r the <br />Iw:ginning ~ d ectii c .+pcr.it ions. and the dale acu, e .q,rmtiuns ecased Ibr the ,ear, i t :ul, <br />I'kasc attach ~mrr rci i+ed ,~ ritu•n annual rcnort and annual rcnort Winn to chi. form. I'Ir~nr rnrlr rlur! urr <br />rrdryrrurl'/c Lrbrhal neu~r rhrrr clrrrrlr drliuerru•~ luu/ inrlude.+ thr Irhurr rldrnenrs nun• .,n~rr h.r rr irriul•rr <br />rdpurT <br />I>nision ren>n1s indicate the ti+Ilui~ing pcnnntee contact intimnation. I'Icaxe terih and ntal.c any neccssan <br />change+: <br />PcrmiucrContact: Glen K. Ausmus <br />Pcmiittee Manic: Baca C',anus <br />\JJress: ' 11 Main tit. <br />~prmglirlJ.l'U 811173 <br />Phone Number ('1')) i,',?_fi;?? <br />I'ax Vumtxr t'IV) 53;-(,>8d <br />If }ou hair a dditional :,+nnnents uuJ4rr intbrntation that ,hould be pn+~ idcd to the I)i~i,iun. plea,c pnnidc it <br />bclo,~ or att ach it n, chi, form ;dung with ~uur i~rinc n rcpon and map. Annual Kcport insinictions arc <br />cncluscJ. <br />! ~ <br />Signaurre of l'orp?nae Uliiecr. I ),i ncr, or I ksigncc <br />I)alc <br />~(r~ 7~ <br />'JS~~ <br />RECF~~/ED <br />AUG 2 3 2006 <br />V-Umaron of ~loclamahon. <br />Mmirw J Sa'ery <br />N .FERMI I'0.U11t RlM R'I!\IFti h M. AI to <br />