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<br /> <br /> <br />ANNUAL REPORT <br />PERMITTEE NAME: Ron Ebberts <br />PERMIT NO.: M-80-038 <br />OPERATION NAME: Disappointment Valle <br />ANNNERSARY DATE: October Ol, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: San Miguel <br />iii-iuiiiuniiiii <br />~~~01/ <br />R~~r,!/rG <br />,I,.., V <br />Division 01 i~Sif:E1aS511 GEO:oOy <br />according to C.R.S. 34-32_ I ] E(31(a). each year, on the anniversary date of the permit, an <br />operator shalLsubmit the annual fee, a report and map_showing_[he_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 <br />annual report. P(ense note that nn adequately (nbe(ed map that clearly delineates and <br />includes the above 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: ~O/') C ~ilj~ h ~'-S <br />Address: ~• O /SOX ~~5`O <br />C Cf ~ c? h . CD • ~/.3e7S• <br />Company: ~fjb~ hZ`S (_On_S i<hCLC~ ~ ol~ <br />Phone No.: (~/ 70) ~ 7 7 - a `/ 7 ~ <br />Fax No.: t 9 70 1 7 7- ,~ 7 7~ <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 />~~f~J~~~ 9 - ~ ~~ - ~ 9 <br />Signature of Corporate Ofticer, or Owner Date <br />INSTRUCTIONS ON BACK <br />