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N- o~~ <br /> ANNiiAi. FF.F. and REPORT RF. l7iTF.ST <br />R~G~~`i."~ <br />~ <br />PERMITTEE NAME: Joseph L. and Arlene Cogan . <br />PERMIT NO.: M-1998-091 FEB 2 3 2004 <br />OPERATION NAME: Aruold Gulch DiyisionolMin <br /> eralsand Geology <br />ANNNERSARY DATE: February 19, 2004 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Chaffee <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-shatving-fhe-extent-of-cun•ent-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 ~nnr revised written annnal report and annual report m ~n to this Snrm_ please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joseph L. Cogan <br />Permittee Name: Joseph L. and Arlene Cogan <br />Address: <br />Phone Number: <br />Fax Number: <br />P. O. Box 113 <br />Nathrop, CO 81236 <br />(719) 395-2339 <br />If you have additional comments andfor 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 />~. v , ~/l. <br />Si a re of Corp//orat fficer, Owner, or Designee <br />Date ~ ' <br />M:~PERMITIMASTERDOCUMENTS4M-AF-01 <br />