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~~ <br />ANNiiAi, FF.F, and RF.PnRT RF.niiF,ST <br />PERMIT"I'EE NAME: Comstock Mining & Refining ~~CE~ ~~ per, <br />PERMIT NO.: M-1988-081 <br />OPERATION NAME: Phil Sheridan Lode AUG 1 g ~ <br />ANNIVERSARY DATE: August 19, 2004 9ipisipn of Minerals and GeWpgy <br />ANNUAL FEE DUE: $75.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <br />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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />occur during the upcoming year, 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 ym~r revised written annual re»nrt and annual report man M this form. Please note that an <br />adequately labeled map that clearly deltneates and includes the above elements may sufface for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Raymond "Rocky" Conner <br />Permittee Name: Comstock Mining & Refining <br />Address: P.O. Box 841 <br />Silver Springs, NV 89429 <br />Phone Number: (775) 230-5523 <br />Fax Number: <br />If you have additional comments andlor 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 are <br />enclosed. <br />.6----- <br />S' a orporate Officer, Owner, or Designee <br />g'- /~ - o ~ <br />Dale <br />N,eG> ~,~cSY"U~®~~S <br />vo ,~ . <br />M:NERMI'nMASTERDOCUMENTS/M-AF-02.D0(, <br />