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~ Ln <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNT!AT, FF.F, and RF.PfTRT RFni!F.RT <br />So. yVay Co. <br />bT-1984-025 ' <br />Stage Stop Pit <br />July 26, 2004 <br />$688.00 (Due on or before your anniversary date) <br />Saguache <br />f~EG;et~j,~~,~+ <br />AUG 14 2004 <br />Division cf Ninarals & GeelogY <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 />sha!! submit the annual fee, a report and map showing the extent of current disturbances to affected iand, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <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 re-p,prt man to ihi.c form. Please note thar att <br />adequately labeled map that clearly delineates and irtc/odes the above e/entents may st fficeJa• a tivritten report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permi[tee Contact: Rock I. Southway <br />Permittee Name: So. Way Co. <br />Address: 117 White Pine Dr. <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-5103 <br />Fax Number: (719) 589-5522 <br />If ycu have additional comments and/or inforration 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 are enclosed. <br />of Corporate Officer, Owner, or <br />~/i.~ %o <br />Date <br />