REP41110

• Permit No: M1997084
• IBM Index Class Name: Report
• Doc Date: 1/20/2004
• Doc Name: 2004 Annual Report
• From: Horizon Ranch LLP
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Horizon Ranch, LLP
M-1997-084
Memphis
February 2,2004
JAN 2 0 1004
Division H Minerals and Geology
$281.00 (Due on or before your anniversary date)
Ouray
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 operator
---shall-submit the-annual-fee, a-report-and map-shewina_the_extent_of.current disturbances_to_affected_land,_ _
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach xpur revised written anmral repQpt and anneal report main to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
PermitteeContact: Reef Gillum
Permittee Name: Horizon Ranch, LLP
Address:
Phone Number:
Fax Number:
P. O. Box 190
Fomey, TX 75126
[phone]
[phone]
~1~2- ~3-31t)u X 1~3
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.

M:~PERMITUTASTERDOCUMENTS4M-AF-01