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~ '-- <br />AV.11 _U.I~F'E:uul ItFI'Ukf RF_Oll?S7" <br />PIiF:~1f1"Ilili N:\MI:: Yluntnnc ('ounty _ `~ <br />PI:RI`11'C NO.: >I-199.-(117 <br />UPI{RATION NA\11 : 131.\I;N'ctit Find Pit ."tAR 2 ?006 <br />ANNIVf Rti:\Rl' D:\ I I•: \prfl 24, 2UU6 ••. <br />ANNUM. I I[I: Dl 1 : >6R8.0U (Doc un or before your annhcrsary date) <br />COl1N'fY': )lnntrosc <br />According to C.R 1. i4•i2.;-I I6 or ('.1(.ti. 34-)2•I I6, each year, on thr anNversary date of the lxrmn. an <br />ol>crator shall submu the annual fee, a report and mop showing the c~tent oC current disturbuncrs w atlirted <br />I:nxl, rcci;unation uccuuq:li.hcd a+ date and during the preceding year. ncu disutr!>:mccs that arc anuctpatcd n, <br />occur durng the upcunung year, rcclamauon that wdl he Itcrtirrntcd during the coming year, the date. lift the <br />hegnuunc o(acnte opertltan., and thr d;ue acute n(xrauons erased lift the vcar. if am. <br />1'Icax• •ruach ~nur retked griuen annual rep~rt~nd anneal reytprl Ill~h ro this fnnn /'It•u.tr nnlN flru! utr <br />~rJ~yururl: GJrrIrJ rnulr Il+;u rlr~ulc Jrlrrr.<ueo onJ uuLrdre thr :rbrni .Irm<•nrc m,r: .u//ict• far a x•rimvr <br />rrtu u'!. .. <br />Diviston n^cottls indicate the following jxrrnrttcc comae[ mfrnmanon. Please verily mtd make any necessary <br />change.: <br />PcrmiUCC Contact: Rrtan Wilson <br />Pcrmitk+c Namc: ~lontrosc County <br />:\ddress: IGI S.7ownscnd <br />4funtrosc,CO 51401 <br />I'hunc Numhcr: 1970) 249-7755 //~ ~~j • oZ J ~ - •700 <br />hax Numhcr: (970) 249-7761 '7 ~ ~- 0"257 - -7 C I O <br />II you have additional comments and~or inf'orntauon that should tx provided to the Division, please provide it <br />hclow or attach it Ut this litmt along with your written report and map. Annual Rrlwrt instructions arc <br />enclosed. <br />Stgnaturc of Corporate Officer, Owner, or Designee <br />i)ate <br />