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<br />~ ~ • ~~ <br />~~~ ~~ <br />ANNUAL REPORT ~9 ~~ <br />PERMITTEE NAME: Melvin T Gydesen <br />PERMIT NO.: M-82-020 RECEIVEL <br />OPERATION NAME: Lucky Strike Lode* <br />ANNIVERSARY DATE: May 25, 1999 ~R 12 ~9~ <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 piyiSipnofMinara158tieologY <br />COUNTY: Gunnison <br />In order to ensure that our records are up to date, please attach your revised annual report map and-written <br />report to this annual report. Note that a written report is not necessarX if the map addresses all the <br />items listed in the attached instructions concerning mining disturbance and reclamation update. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: ~~n1/ /N ~ ~rY~ eS e rt/ <br />Address:: ~-a"9 ~U u,UTy ~} (f` <br />~' u ~vNi 5.6 K/ Ca a h o 8/a-3 0 <br />Company: f.y G~~~' S/~//lC~ h°~ <br />Phone No.: (~7~ 1 In ~~ - ~3 9~ <br />Fax No.: <br />Signature of Corporate fficer, or Owner <br />S~ /y9 <br />Date <br />/NSTR UCTIONS ON BACK <br />M \DNRML\MASTEIiD\M-AF-OZ <br />