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ANNUAL FEE and REPORT REQUEST <br />RECEIVE® <br />MAR 15 2002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Montrose County <br />M-1992.017 <br />BLM/West End Pit <br />April 24, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Montrose <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />` _l a`nd?eclamation-accomplished-m~date=artd-during-the=preceding=yeas,=new_disturbances_t]tat_a[eanticipated_to <br />occur during the upcoming year, reclamation that will be performed during the coming year, [he dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual resort and annual resort mao to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Brian Wilson <br />Permittee Name: Montrose County <br />Address: 161 S. Townsend <br />Phone Number: <br />Faz Number <br />Montrose, CO 81401 <br />(970)249-7755 <br />(970) 249-7761 -- - - - - -- ~ - -- - - --- <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach it to this form along with your written report and map. Annual Report instmctions are <br />enclosed. <br />tgnature of Corporate Officer or Owner <br />~ ~81~s Z <br />Dat~-~ <br />M:~PERMnN4ASTERD000MENTSUI-AF-04 <br /> <br />