2004-05-12_REPORT - M1982020

• Permit No: M1982020
• IBM Index Class Name: Report
• Doc Date: 5/12/2004
• Doc Name: Annual Fee/Report/Map
• From: Melvin R Gydesen
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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Melvin R Gydesen
M-1982-020
Lucky Strike Lode
May 25, 2004
~~
PERMTITEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

MAY 12 2004
Division of Minerals & Gaolopy
$225.00 (Due on or before your anniversary date)
Gunnison
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
_ ~peratorshalLsubmit_Yhe annual fee, a report and m_ap showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are ant~cr-'-`pate-1 ~o
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual re~nrt main to this form. please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact:
Permittee Name:
Address:
Melvin R. Gydesen
Melvin R Gydesen
229 CR 11
Gunnison, CO 81230
Phone Number: [phone]
d
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Cof Corporate Of cer, Owner, or Designee
~~
Date
MiPERMIT~T.fASTERDOCUMEMS/M-AFA2.DOC