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• -- <br />~II II~II~II~II~~ II~ <br />999 <br />ANh~~.~ ..._._ <br />PERMI'ITEE NAME: City of Monte Vista <br />PERMIT NO.: M-92-060 <br />OPERATION NAME: Lagoon Pit <br />ANNIVERSARY DATE: October 20, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />CC)UNTY: Rio Grande <br /> <br />®® <br />. - ~~ <br />~CEIVED <br />OCT L 2 1999 <br />;nnerab & Geo-o9Y <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 year, new <br />disturbances that aze anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. P/ease note that un arleyuutch labsled map that c/cur/t' delineates and <br />includes the abuse elements nom .suffice fur a rcrNtea report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />;pace provided: <br />Contact Name: Dave Howard <br />Address: 4 Chico Camino <br />CORtpany: City of Monte Vista <br />Phone No.: ( 719 ) 852-2692 <br />Fax No.: ( 7t9 ) R57_6179 <br />if there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />~~ ~ma <br />~' ~~ ~ ~~ <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />