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rnC~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNiiAi. FF.F, and REPORT RF.nIIF,ST <br />d Russell D Neesham <br />~M-1977-500-UG <br />Peggie Mines <br />June 29, 2006 <br />$225.00 (Due on or before your anniversary date) <br />Montrose <br />RECElVE© <br />~~`~ JUN 2 6.2006 . <br />pivision of Minerals end OeoloAY <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of [he permit, an <br />operatorshall submit the-annual-fee, a report and,map showing the extent of current dis±urbances 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 +~r revised written annnal rennrt and annnal re nrn t man to this form- please note that atr <br />adequately labeled map that clearly delineates and includes the above elements pray suffice for a tvrittetr <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Russell D. Neesham <br />Permittee Name: Russell D Neesham <br />Address: P.O. Box 314 <br />Nucla, CO 81424-0314 / <br />Phone Number: .._4g4g}cg~{r7-~ .. . - / ~ ~GS) ~~~j ~ - ~~~~ V <br />Fax Number <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 />ign(ature of Corporate Of/ficer, Owner, or Designee <br />Date <br />M:~PERMI71MASrERD000MENTS/M-AF-02.DOC <br />