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• iiiiiiiiiiiiiiuiu <br />ANNUAL REPORT <br />PERMITTEE NAME: Ed Loloff Construction Inc <br />PERMIT NO.: M-85-112 <br />OPERATION NAME: Ed Loloff Const Inc <br />ANNIVERSARY DATE: February 04, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Weld <br />~d~C~'y~c <br />G~ ~s~ <br />~~~~ <br />~~CE-fV~D <br />JAN 05 1999 <br />ion of Minerals 8 Geobgy <br />Please attach to this annual report yoer revised anrua! repent map and v::ittcn report. ~y'ote that a w~itien <br />re ort is not necessar if the ma addresses all the items listed in the attached in tractions <br />concerning mining disturbance and reclamation uadate. Also, if all of the reporta le conditions listed <br />in the Annual Repot[ instructions have not changed since the last Annual Repot[ map $nd report were <br />submitted, then a revised map is not required. Please indicate the correct response bet w. <br />^ UPDATED MAP ATTACHED <br />r~XCONDTTIONS UNCHANGED, LAST SUBMITTED MAP REFLECTS CURREtI1T CONDITIONS <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: Ed Loloff Company: Loloff Construction. Inc <br />Address:: <br />Kersey, CO 80644 <br />PhoneNo.:~a,~_) 3ra3_}6~1 <br />Fax No.: ( 970) 356-0963 <br />Comments:: <br />No changes since last report <br />/~~.~~ <br />~' <br />Signature of Corporate Officer, or Owner <br />January 4,1998 <br />Date <br />M.IDNRM LNIASTER DUt ~ AF-01. <br />