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~ III IIIIIIIIIIIII III <br />999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Sanborn Sand and Gravel <br />PERMIT NO.: M-1984-094 <br />OPERATION NAME: Gloria Z Mine <br />ANNNERSARY DATE: July 17, 2000 <br /> <br />RECEIVED <br />J',~L 1 <br />,,;.on of Mittetats & Geo1o9Y <br />1~a 111 ~~ a~~ <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 `~,~ ~,~Q ,~.~~Q <br />COUNTY: Park 8~`bt"J~'_~ <br />According_to C.R.S_34-33-1 lfi(31(a). each tear, on.the_annivErsary date of the_pertuit, att_oneiator shall-_ <br />submit [he annual fee, a report and map showing the extent of current disturbances [o affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for [he beginning of active operations, and the date active operations ceased for [he year, if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />nose that an adequately labeled map that clearly delineates and inchules the above elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in [he space <br />provided: <br />sf{>\1L ~A B, SRNBo,RN Com an SANBoRN SAND y-GRAVe ~ ~ rNc <br />Contact Name: ~ ' <br />P Y~ <br />Address: PD Box ,3 ~ ~ <br />FH/2 ~ ~A` 1i ~. S'o v ya <br />Phone No.: (7/ 9 ) ~3 6 - a yo 6 <br /> <br />e-mail: betty ®cha{'f'ee~!'yeT <br />If there are additional comments and/or information [ha[ should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signature of Corporate Officer, or Owner Dale <br />INSTRUCTIONS ON BACK <br />M.~PER M ITN7 ASTERDOCU Al ENTSN7-AF-01 <br />