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<br />RECEIVED <br />PERMITTEE NAME: Lincoln County <br />PERMIT NO.: M-2002-017 <br />OPERATION NAME: O'Dwyer <br />ANNIVERSARY DATE: March 26, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Lincoln <br />Accordin¢ to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary d <br />operatoi shall~submit'the annual-fee,-a repo and map'showing the ezteti[_of current disturSarlces [o affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are 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 year, if any. <br />Please attach ynnr revised written anm~al re~nrt and anneal report main 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Don Blake <br />Permittee Name: Lincoln County <br />Address: 103 3rd. <br /> <br />JAN 15 2p03 <br />Division of Minerals and Geology <br />P.O. Box 39 <br />Phone Number: <br />Fax Number: <br />Hugo, CO 80821 <br />(719)743-2337 <br />(719)743-2815 <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 forth along with your written report and map. Annual Report instructions are <br />enclosed. <br />~6~ <br />Signature of Corporate Officer, Owner, or Designee <br />Date ~ <br />M:IPERMITMASTERDOCUMENTSVv1-AF-04 <br />