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~ ~J <br />RECEI~lED <br />ANNUAL FEE and REPORT REQUEST <br />MAY 0 8 2002 <br />Division of Minerals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Alvin Mosch -Patricia Mosch <br />M-1982-075 <br />Phoenix Mine <br />June 14, 2002 <br />$225.00 (Due on or before your anniversary date) <br />Clear Creek <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an <br />- -operator-shall-submit-theannual_feera_repart_and_mapshowing~he_extent_oLcurrent_disturbances_to_affecied <br />land, reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated to <br />occur during the upcoming yeaz, 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 vour revised written annual report and annual report map 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 />Permi[tee Contact: Alvin Mosch <br />Pemuttee Name: Alvin Mosch -Patricia Mosch <br />Address: Box 3236 <br />Idaho Springs, CO 80452 <br />Phone Number: (303) 567-0422 <br />Fax Number: <br />C-!~ o-(~ 2oL~ <br />13 ~l xlC ~ n ,° cL~s-~ r3- <br />.,.. ~ ~ ~~ ~-/ ~ clG ~y CL <br />~) a e 6G ~ r7-K .~.-~ ti- a <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 aze <br />enclosed. <br />Signature of orporate Officer or Owner ~- ~ ~ ~ ~ ~~ ~/'/ <br />~(ee(i~Uvt l~Sc~~l~~fJ' <br />Date l ~ // U ~ <br />M:~PERM ^NiASTERDOCUMENTS/M-AF-02.DOC <br />