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<br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Pope Pit #2 <br />M-1986-101 <br />Pope Pit No 2 <br />September 12, 2002 <br />SEP 10 2002 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Pueblo <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 operator <br />_ shall submit the ann_ual_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 to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />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 map to this form. Please note that an <br />adequately labeled map that clearly delineates and Includes the above elements may suffice for a written report. <br />Division records indicate the following permi[tee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Walter T. Pope <br />Permittee Name: Pope Pi[ #2 <br />Address: 1947 Siloam Rd. S. <br />Pueblo, CO 81005 <br />Phone Number: (719) 784-3282 <br />i./~+ `TER r-- ~o/°E <br />~7I~y7S~LaANIi~'Jj-~ <br />/ U~BL O ~O ~o Fr/DDS' <br />719 78~ ~a~'~. <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 enclosed. <br />~ ~ ~~ <br />Signature of Corpo/ra[e Officer, Owner, or Designee <br />< !u <br />Date <br />M:IPERM ITNIASTERDOCUM F.NTSUI-AF-01 <br />