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• • iii iiiiiiiiiiiu iii <br />999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Las Animas County ~ECE~VED <br />PERMIT NO.: M79163 ~C) 1 ~ 1999 <br />OPERATION NAME: Shannon Pit ''o''c''Mtnera~~ , <br />~eolotdY <br />ANNIVERSARY DATE: September 27, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Las Animas <br />According to C.R.S. 34-32-1 16(3)(a), each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and [he date active operations ceased for the <br />year, if any. <br />Please attach vour revised annual report map and written report to this annual report. Please <br />note that an adequately labeled map that clearly delineates and inch<des dte above elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: 1pClo c°r`J ~Gllc°~'O <br />Address: ~0U G= . /~~s f ~i„ ~U / <br />Company: ~AS 9~~~.rr C"Gu~~y <br />Phone No.: (9/9) c~ //~- `/Y~~ <br />Fax No.: (~/ s) c~Y~- 7/( 0 <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />~~~ A ~/-~~.,~ is :~- 9 9 <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />