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_,., <br />~, <br />RECEIi/E® <br />PERMITTEE NAME: Virgil B. and Lorraine E. Mitchell OCT 2 3 2003 <br />PERMIT NO.: M-1980-193 <br />OPERATION NAME: Sokol Pit Division of Minerals and Geology <br />ANNIVERSARY DATE: October 23, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: EI Paso <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <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 ynnr revised written anneal re~nrt and anneal rennrt main to this form. please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Virgil B. Mitchell <br />Permittee Name: Virgil B. and Lorraine E. Mitchell <br />Address: 29975 Harrisville Rd. <br />Calhan, CO 80808 <br />Phone Number: (719) 347-2259 <br />Fax Number: '-719• '34~' 213q <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 />~~ <br />Sign~atur of Corporate Officer, Owner, or Designee <br />~O~Z~~~ <br />Date <br />M:~PERMITVNASTERD000MEMSVN-AF-04 <br />