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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Las Animas County <br />M-2001-015 <br />Sandoval Land and Cattle Pit <br />May 17, 2003 <br />?!1 {; ~" ?003 <br />RECEIVE® <br />APR 2 5 2003 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Las Animas <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 shal2-sulimtt-the annual-fee; a repoR snit-map slsowin~-the-ezterit of current disturbattcesZO 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 attarnynur revised written anneal rennrt and anneal report m to this form. please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffrce 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: Phil Dorenkamp <br />Permittee Name: Las Animas County <br />Address: 2000 N. Linden Ave. <br />Trinidad, CO 81082 <br /> <br />Phone Number: <br />Fax Number: <br />(719)846-4766 ,. <br />(719)846-0434 <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 are <br />enclosed. <br />M: W ERMIT~MASTERDOCUM ENTSVN-AF-04 <br />