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=n . <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Gary Boyce <br />M-1985-085 <br />Rancho Rosado <br />April 17, 2002 <br />I YJ" <br />APR 18 2002 <br />Division of Idinerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Saguache <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 the annual fee, a report and map showing the extent of current disturbances_[o_affecte¢_land,.-- _. <br />-"' reclamation accomplished to date-and duffing the p~ecedirig year, new disturbances [hat are anticipa'[ed to occifr <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gary C. Boyce <br />Permittee Name: <br />Address: <br />Gary Boyce <br />17425 CR 66T <br />e~~~ <br />t' <br />N <br />Do iyoT vS.t' r3o,r ~ <br />Moffat, CO 81143 <br />Phone Number: (719) 256-4613 <br />,Fax Number: ___(719) 256-4318 _ .~_ <br />~~ <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 aze enclosed. <br />~- <br />S ture f Ca or Of tcer or Owner <br />/ri i~ ~.~ i c. ~ OZ <br />Date <br />I. <br />M:~PER M IT Vvt AST E RDOC U M ENTSU4-A F-01 <br />