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_. ~ • <br />III'lllllll~llll ~I~ <br />ANNUAL REPORT <br />PERMITTEE NAME: Prowers County <br />PERMIT NO.: M-84-134 <br />OPERATION NAME: Randy Shaw Pit <br /> <br />DECEIVED <br />AUG 19 1999 <br />-~s:un of Minerah 8 <br />ANNNERSARY DATE: August 31, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Prowers <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the pei <br />operator shall submit the annual tee, a report and map showing the extent of curve <br />to affected land, reclamation accomplished to date and during the preceding yeaz, <br />disturbances that are anticipated to occur during the upcoming yeaz, reclamation tl <br />performed during the coming year, the dates for the beginning of active operations <br />active operations ceased for the year, if any. <br />a[tnual I'eAOrt. Please note that an adequately labeled map that clearly <br />i~tcludes the above elements mny suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone <br />space provided: <br />Contact Name: DONALD KOEHN Company: PROWERS COUNT <br />Address: 109 E. SHERMAN ST. <br />LAMAR. CO 81052 <br />Phone No.: (719 ) 33 <br />Fax No.: <br />'~I11/ <br />ut, an <br />disturbances <br />n will be <br />and the date <br />nud <br />in the <br />If there aze additional comments and/or information that should be provided to the ivision, <br />please provide it on a separate sheet and attach it to this report form along with yo map and/or <br />written report. <br />~Bvt 0~ Q.o~ <br />Signature of Corporate Officer, or Owner <br />'J~ 13--9 <br />Date <br />INSTRUCTIONS ON BACK <br />