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• III IIIIIIIIIIIII III <br />ANNUAL REPORT <br />PERMI'ITEE NAME: Bent County <br />PERMIC NO.: M-91-086 <br />OPERATION NAME: Earl-Hoffman-Reyher <br />ANNIVERSARY DATE: October 03,1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Bent <br />• ~ ~~ ~o <br />RECEIVED <br />SEP 1 4 2000 <br />Division of Minerals and Geology <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator' shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed daring the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised mum~l report map ~nrl written report to this <br />annual rehOt't. Pleasc note tl+at rut udegrrrurf~ labr(cd Wrap phut clcurh dcliuruirs u+rd <br />inclu+les the crbore elements mqy suffice ja' a n•rilten report. <br />Please type or print the current contact pzrson's name, mailing address, and phone number in the <br />space provided: <br />Contact N;tme: Virlev Burkhalter <br />Address: p.0. Sox 350 <br />Las Animas, Co. 81054 <br />Compan}~: Bent County <br />Phone No.: (719 )456-2223 <br />Fax No.: (719 ) 456-0375 <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it to this report form along with your map and/or <br />written report. <br />+ <br />' i n./' „~ J ~;~ 8/31/99 <br />Signatufe%f Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />