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• III IIIIIIIIIIIII III <br />999 <br />ti <br />ANNUAL REPORT <br />PERMITTEE NAME: Park County <br />PERMIT NO.: M-1997-035 <br />OPERATION NAME: Chaparral 2 <br />ANNNERSARY DATE: July 21, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Park <br />-~ <br />~~ ~ ~~ <br />RECEIVED <br />dU! 14 2000 <br />Delon of Minerals & Geology <br />According to C.R.S. 34-32-I 16(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding yeaz, new <br />disturbances that are anticipated [o 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 annual report. <br />Please note that an adequately labeled mnp that clearly delineates and includes the above <br />elerrrerrrs may suffice jor 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: Robert L. Vance Company: Park County Road and Bridge <br />Address: Po13 147 Phone No.: ( 719 ) 836-4263 <br />Fairpla~, CO 80440 FAX No.:( 719) 836-4275 <br />e-mail: vance@amiao.net <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 />'~,~5 U - - ~ - ~ 7 - n r7 <br />S' nature of Corporate Officer, or Owner Date <br />/NSTRUCTIONS ON BACK <br />M.~PERM fM1ASTERDOCl1MENTSV.I-AF-6f <br />