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~i"~ „ • • <br />1st lO® <br />ANNUAL REPORT <br />PERIvIITTEE NAME: Montrose County p ~~~~~~~ <br />PERMIT NO.: M-,,~ /LI - ~D 3 -Z~~ <br />I~AY i 2 2000 <br />OPERATION NAME: ~~ja` DG/~/O p J~' <br />~~ivision oFMinerais & Geology <br />Ali 1NIVERSARY DATE _ ~//l/~ 7,`~D <br />P.i~INUAL FEE DUE ON ANNIVERSARY DATE: $ ~O' <br />COUNTY: Montrose <br />According to C.R.S. 34-32-116(3)(a), 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 <br />to affected land, reclamation accomplished to date and during the preceding yeaz, new <br />disturbances that aze anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming yeaz, the dates for the beginning of active operations, and the date <br />active operations ceased for the yeaz, if any. <br />Please attach your revised annual report map and written report to this annual report. <br />Please note that an adequately labeled map that clearly delineates and includes the above <br />elements may suffice for a writen report. - <br />Please type or print the current contact person`s name, mailing address, and phone number in the <br />space provided: <br />Contact i\~.i~i~. / ~.~/.S~ <br />Address: n ~ / <br />Company:,;:/1~J7~I?l,~c LOGi~ <br />Phone No.:l .71 ) ~ 77.5 <br />FAX No.: (~~9 l02 Sig 77~ / <br />If there aze additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it to this report form along with your map and/or <br />written report. , <br />~~ tpor Officer Ow~ Date <br />INSTRUCTIONS ON BACK <br />M 1PERMRNIAS7ERD000MEM'N7-AF-oJ <br />