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~ iii iiiiuiiiiiu iii ~ <br />ANNUAL REPORT <br />PERMITTE.E NAME: Jordan C. and Jone L. Burdick ~~~'~~~~L' <br />PERMIT NO.: M•1987-092 •.Il1N I !~ 200 <br />OPERATION NAME: B & G Stone r~sion otMinerals & Geology <br />ANNNER:~ARY DATE: August 25, 2000 ® ~ <br />ANNUAL F'EE DUE ON ANNNERSARY DATE:Sl.A <br />COUNTY: Latimer <br />According to C.R.S. 34-32-1 l6(3)(al, each year, on the anniversary date of the permit, an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attachour revised annual report map and written report to this annual report. Please <br />note that an adequately labeled map that clearly delineates and includes die above elements mny <br />Buff ce for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: ~J~-S <br />~'otv e <br />Contact Nante: r t~ <br />Address:y ~ 6 <br />~~,Lanr.S ~D ~6CS'S' <br />~~t~sralve~ <br />Company:•L(ix• ~ v ]~~ S ~7~ nib. <br />Phone No.:~x,Z3 ~ rr'S~3 <br />FAX No.: <br />e-mail: <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />J <br />Si azure of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />M:WERMI-MIASTEF DOCUAIEMSU1-AF-01 <br />