2000-11-02_REPORT - M1986105

• Permit No: M1986105
• IBM Index Class Name: Report
• Doc Date: 11/2/2000
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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999
ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Hourglass, Inc.
M-1987-150
Phyllis "E" Mine
November 2, 2000
c;~l ~ 1 ~ S g ~ ~b ~
RECEIVED
NOV 0 2 2000
Division of Minerals and Geology
$688.00 (Due on or before your anniversary date)
EI Paso
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
- --'opemtorsha}I-submit themnnual-fee,-a-report and-map-showing-the extent-of currenFdisturbances-to affected-
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adequately labeled reap that clearly delineates ant! includes the above elemerus may suffice for a written
repor7.
Division records indicate [he following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact
Permittee Name:
Address:
Phone Number:
Fax Number:
hhaa.li: U~la
Sh~l4~a'Veneziz
Hourglass, Inc.
7710 N. Union Blvd.
Colorado Springs, CO 80920
[phone]
[phone]
If you have additional comments and/or information that should be provided [o the Division, please provide i[
below or attach it to this form along with your written repon and map. Annual Report instructions are
enclosed.

Signature of Corporate Officer or Ov~ner ~` ~~
1031 MoD
Date

A7: WERMfIw1A5TERD000MENT5UI-AF-01