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i' <br />~ • ~ III IIIII~~~IIIIIIII <br />ANNUAL REPORT <br />LK ~ 12.30' ~ ~~l"~ <br />~ RECEIVED <br />ocr 2 32~ <br />^ivision of Minerals and Ge01og~ <br />PERMTI'TEENAME: 114+ke-C~Ietxae~r~3erey~eifePt Seifert Construction <br />PERMIT I'10.: M-1991-083 <br />OPERATION NAME: Ula Pit <br />ANNNER:SARY DATE: October 29, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $281.00 <br />COUNTY: Custer <br />Accordi~;g to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the pernut, an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated <br />to occur during the upcoming yeaz, reclamation that will be performed during the coming year, the <br />dates For the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report map and written resort to this annual resort. Please <br />note that an adequately labeled map that clearly delineates and includes the 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: Marv Seifert <br />1'.0. Box 305 <br />Glestcliffe. CO 81252 <br />Company: Seifert Construction <br />Phone No.: (719 1 783-2757 <br />FAX No.: ( 1 same <br />e-mail: <br />If there are ,additional comments and/or information that should be provided to the Division, please <br />provide it a1 a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signature f Corpor to Office , or Owner <br />10-18-00 <br />Date <br />INSTRUCTIONS ON BACK <br />M' W E R M FI V.1 AST E R DOC U M E M'S N1- A F-01 <br />