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0 �� C- <br /> J <br /> ANNUAL REPORT <br /> PERMITTEE NAME: Bent County Ready Mix RECEIVED <br /> PERMIT NO.: M-95-007 <br /> OPERATION NAME: Thomeczek Pit <br /> ANNIVERSARY DATE: February 06, 1999 Division of Minerals&Geology <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br /> COUNTY: Bent <br /> Please attach to this annual report your revised annual report map and written report. Note that a written <br /> -- report is not necessary if the map addresses all the items-!isted-in the attached instructions — — <br /> concerning mining disturbance and reclamation update. Also, if all of the reportable conditions listed <br /> in the Annual Report instructions have not changed since the last Annual Report map and report were <br /> submitted, then a revised map is not required. Please indicate the correct response below. <br /> ❑ UPDATED MAP ATTACHED <br /> CONDITIONS UNCHANGED, LAST SUBMITTED MAP REFLECTS CURRENT CONDITIONS <br /> Please type or print the current contact person's name, mailing address, and phone number in the space <br /> provided: L / <br /> Contact Name:- )667 �[D�0 ��Cz�� Company: �/ c <br /> Address:: � "�� 397 Phone No.: <br /> A5 Uyl Fax No.: ( ) <br /> CO UD 5 -038 <br /> Comments:: <br /> gnature of Corporate Officer, or Owner Date <br /> At:ONRMLWASTERDW-AF 04. <br />