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LK (#`~-I~(al~ \~~`JO ~ <br /> <br />• PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME; <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />White River Nahcolite Minerals <br />M-1983-194 <br />Nahcolite Project <br />January 31,2001 <br />RECEIVED <br />JAN 2 9 2001 <br />Givision of Minerals and Geology <br />$550.00 (Due on or before your anniversary date) <br />Rio Blanco <br />According [o C.R.S. 34-32.5-116 or C.R.S. 34-33-1 I6, each year, on the anniversary date of [he permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated [o <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 your revised written annual report and annual resort map to this form. Please note that crn <br />adequately labeled map thu[ clearly delineates and includes [he crhove elements may suffice for n written <br />repot[. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />• Permittee Contact. Ed Baker /"~ /~ 2 <br />Permittee Name: White River Nahcolite Minerals <br />Address: 3200 CR 3 I <br />P.O. Drawer 72 <br />Rifle, CO 81650 <br />Phone Number: (970) 878-3674 <br />Fax Number: (970) 878-5866 <br />-f 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 />c~,c~ <br />Signature of Corporate Officer or Owner <br />-I~~,r~6~o?00l <br />• Date <br />ANNUAL FEE and REPORT REpUEST <br />M ~PERMITNIASTERDOCUMENTS/M-AF-01 DC1C <br />