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Y. f. <br />ANNUAL FEE and REPORT REQUEST <br />APR 1 0 2002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Fremont County <br />M-1999-033 <br />Howard Pit #1 & #2 <br />May 26, 2002 <br />RECEIVED <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Fremont <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[o date_and during.the preceding_year; new disturbances-that-are anticipated-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 your revised written annual report and annual resort mau to 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: <br />Permittee Name: Fremont County <br />Address: Fremont County Commissioners <br /> 615 Macon Ave., Room #105 <br /> Canon City, CO 81212 <br />Phone Number: (719) 276-7320 - <br />Fax Number: (719) 275-762b <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 />~-5 - ~ <br />r <br />Si ature of Corporate Officer or Owner <br />Dale <br />M 1PERMnN1ASTERD000MEMSN4-AF-01 <br />