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rca <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />B -Mining Company <br />M-198(x102 <br />Deep Creek Placer <br />September 4, 2003 <br />CEIVED <br />~~9~ t~r,....._ ....._ __ <br />$281.00 (Due on or before your anniversary date) <br />San Miguel <br />According to C.R.S. 34-32.5-1 l6 or C.R.S. 34-32-116, 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 land, <br />reclamation accomplished [o 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 ynnr revised written an .al r ynrt and anneal rennrt _ao to this form. Please note that an <br />adequately labeled map that clearly delineates and inc/udes the above elements may suffice far a written reporr. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: DvPU~~.~ eo~rES q-rj : `~ <br />Pennittee Contact. Michael Moore <br />Permittee Name: $ -Mining Company <br />~~ <br />Address: P.O. Box 326 <br />Nucla, CO 81424 <br />Phone Number: (970) 864-7814 <br />Fax Number: <br />~ , . .~ - <br />~t r1 <br />~ttit~tn~ ,~~ ~S~ <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />to e of Co poste Officer, Owner, or Designee <br />Date V ~ ~ ~ ~/ <br />p/ y Gt 171 P'ln ~ /LC.Gt bit t E'+~ltivPvLY <br />J <br />