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<br />PERMITTEENAME: Mine Development, Inc. i'a~~srC~~~~ <br />PERMIT NO.: M-1981-165 <br /> GCT 0 0 2003 <br />OPERATION NAME: Neglected Mine <br />ANNIVERSARY DATE: October 2, 2003 ~i•/ision at od rb end Genln^" <br />ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br />COUNTY: La Plata <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 />land; reclamation-accomplished-ta-date-and-during the'prece-dittgyear~ tsett~di'sturliances'that-are anticipat-ed to <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 vrnnr revised written annual report and annual rernrt m~ fn 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 />Permittee Contact: Harold E. Lunar 5 ~~ <br />Permittee Name: Mine Development, Inc. r <br />Address: 3319 E. 4th Ave. ~~ <br /> <br />Durnango, CO 81301 <br />Phone Number: (970) 247-1'652 <br />Fax Number: (281) 578-3159 <br />-r <br />~i <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 are <br />enclosed. <br />%~~c%~~ <br />Signature of Corpora[ Officer, Owner, or Designee <br />03 <br />Date <br />M:IPERMITVNASTER DOCUM ENTS/M-AF-02.DOC <br />