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• • iii iiiiiiii <br /> ANNUAL FEE and REPORT REOUEST RECEIVED <br /> MAR 2 0 2001 <br /> PERMITCEE NAME: Park County Division of Minerals and Geology <br /> PERMIT NO.: M-1980-251 <br /> OPERATION NAME: Ansley Flat Pit <br /> ANNIVERSARY DATE: April 1,2001 <br /> ANNUAL FEE: $281.00 (Due on or before anniversary date) <br /> COUNTY: Park <br /> According to C.R.S. 34-32.5 or C.R.S. 34-32-116,each year. On the anniversary date of <br /> the permit,an operator shall submit the annual fee, a report and map showing the extent <br /> of current disturbances to affected land, reclamation accomplished to date and during the <br /> preceding year, new disturbances that are anticipated to occur during the upcoming year, <br /> the dates for the beginning of active operations,and the date active operations ceased for <br /> the year, if any. <br /> Please attach Your revised written annual report and annual report man to this <br /> form. Please note that an adequately labeled map that clearly delineates and includes <br /> the above elements may suffice for a written report. <br /> Division records indicate the following permittee contact information. Please verify and <br /> make any necessary changes: <br /> Permittee Contact: bou r -4 <br /> Permittee Name: i-le CD MTLI <br /> Address: D o K 1 -7 <br /> r R co-, S0440 <br /> Phone Number: /q - 270 <br /> Fax Number: 7/ B34, 275 <br /> If you have additional comments and/or information that should be provided to the <br /> Division,please provide it below or attach it to this form along with your written report <br /> and map. Annual Report instructions are enclosed. <br /> Signature of Corporate Officer or Owner <br /> Date <br />