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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />ZMK Mine Construction Inc <br />M-1991-146 <br />ZMK Gravel Pit <br />August 27, 2001 <br />DECEIVED <br />A~' 1 ' ?001 <br />DiVlSion o/Minerals and Ceoingy <br />$281.00 (Due on or before your anniversary date) <br />Ouray <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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual reuort mao to this form. Please note r/rnr mt <br />adequately lnbeled mnp rhnr clearly de/ineates and includes the above elements rnny since for u reritten report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Robert A. Larson <br />Permittee Name: ZMK Mine Construction Inc <br />Address: 342 7th Ave. <br />P.O. Box 85 <br />Phone Number: <br />Fux Number: <br />Ouray, CO 81427 <br />(303)325-4600 <br />(970)325-4600 <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 enclosed. <br />Signature of Corpor to Officer or Owner <br />S /~4/~~ <br />Date <br />M.V'ERNI IUTA57 F.RUOI'UMENTSN7-AP-01 <br />