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III IIIIIIIIIIIII III �- � ���s� <br /> ANNUAL sss <br /> PERMITTEE NAME: Baca County RECEIVED <br /> PERMIT NO.: b1-95-019 <br /> MAY 10 1999 <br /> OPERATION NAME: Mundell Estate No. 32 <br /> ANNIVERSARY DATE: May 01, 1999 Div60o.1Minetats&Geolo9Y <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: S225.00 <br /> COUNTY: Baca <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 necessary if the map addresses all the <br /> Gems listed in the attached instructions concerning mining disturbance and reelarzatior. 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: RAY MILLER Company: BACA COUNTY DIST, I <br /> Address:: 741 MAIN ST. Phone No.: ( 719 ) 523-6532 <br /> SPRINGFIELD. CO 81073 Fax No.: ( 719 1 523-6584 <br /> Comments:: qll <br /> Signature of Corporate Officer, or Owner Date <br /> INSTRUCTIONS ON BACK <br /> NI?UNRN1LMAS'I I.RDW AP 04. <br />