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• III IIIIIIIIIIIII III br,I <br /> 999 <br /> r <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> PERMITTEE NAME: Bill Kobobel FEB 2 2 2001 <br /> PERMIT NO.: M-1991-123 Division of Minerals and Geology <br /> OPERATION NAME: Idaho Creek Resource <br /> ANNIVERSARY DATE: March 10,2001 <br /> ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br /> COUNTY: Weld <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 /> operator 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 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 your revised written annual report and annual report man to this form. Please noto tho' up, <br /> adequately labeled nrap that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact Bill Kobobel <br /> Permittee Name: Bill Kobobel <br /> Address: 7909 WCR 5 <br /> Longmont, CO 80504 <br /> Phone Number: (303) 772-6916 <br /> Fax Number: (303) 774-9808 <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 /> Signature of Corporate Officer or Owner <br /> — 62 <br /> Date <br /> M APERMITNASTERDOCUMENTSW-A.F-01 <br />