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~- <br />• <br />ANNUAL REPORT <br />PERMTI'TEE NAME: City of Cripple Creek <br />PERMIT NO.: M93039 <br />OPERATION NAME: Midland Gravel Pit* <br />ANNIVERSARY DATE: August 4, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: 225 <br />COUNTY: Teller <br />• iii iiiiiiiiiiiiiiii <br />999 <br />RECEIVED <br />~~~;. ;.. 1~i~J9 <br />ui~sion of Minerals & GeolagY <br />According to C.R.S. 34-32-1 16(3)(a), each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and [he date active operations ceased for the <br />year, if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that an adequately labeled mnp that clearly delineates and inchules the above elements may <br />since for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: r!'ll~p f/uFF,rwnt Company: l_./Tv Of' ~.~tl/t U¢r~it <br />~- <br />Address:_Ro7 L'or,~.TY /Ad. !t Phone No.: (Z/t) fi99- .~/tS <br />C/t ~/c ~u/1, ~a Yet/s Fax No.: (7/9) d 39 - o/R / <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a sepazate sheet and attach it to this report form along with your map and/or written <br />report. <br />Lii~.~=0 ~~ ~til~--~- /o - / S-9~ <br />Signat~rporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />