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ANNUAL I`EE dnd REPORT REQUEST <br />PERMITTEE NAME: Gil Moser <br />PERMIT NO.: / M-1990-059 <br />OPERATION NAME: Eldorado-Pilot <br />ANNIVERSARY DATE: May 21, 2007 <br />ANNUAL FEE DUE: $$75.00 (Due on or before your anniversary date) <br />COUNTY: Ouray <br /> <br />'~ ~;~~~~ <br />. ~ . q~~ <br />~~' 1 ~ 201 <br />Oii~;;+; <br />L.inm, ~,l . ' +ir+'a, <br />- ',i~ <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 />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 attach vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following compouents: fee. report, and <br />associated man. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gil Moser <br />Permittee Name: <br />Address: <br />Gil Moser <br />705 Crestview Dr. <br />Farmington, NM 87401-9106 <br />Phone Number: (505) 860-1728 <br />Fax Number: (505) 564-9609 <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 />~~_ <br />Signature of Corporate Officer, Owner, or Designee <br />~~y~ 7 <br />Date <br />r~•.. GA~+~. z 40 <br />M:IPERMIrU1ASrERDOCUMEMSMt-AF-02.DOC <br />