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- i <br /> ANNUAL REPORT <br /> PERMITTEE NAME: Park County <br /> PERMIT NO.: M-1995-021 MAR 2 4 2000 <br /> OPERATION NAME: Chaparral Pit MAslon of G:irara;s 6 C-X!Cgy <br /> ANNIVERSARY DATE: April 24, 2000 <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br /> COUNTY: Park <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 during 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 annual report map and written report to this annual report. <br /> Please note that an adequately labeled snap that clearly delineates and includes the above <br /> elements may suffice for a written report. <br /> Please type or print the current contact person's name, mailing address, and phone number in the <br /> space provided: <br /> Contact Name: r�.7 L. t/4"c' Company: 7R,�— ,A 7,. P� la�c ,rlge <br /> Address: /�t� /,9 Phone No.: ( -7tg ) S36 - <,•2$3 <br /> e-,e -J4Yc7 FAX No.: 83v YZ75 <br /> If there are additional comments and/or information that should be provided to the Division, <br /> please provide it on a separate sheet and attach it to this report form along with your map and/or <br /> written report. <br /> Signature of Corporate Officer, or Owner Date <br /> INSTRUCTIONS ON BACK <br /> M.I ER M ITMASTER DOCUM ENTSW-AF-OJ <br />