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999 <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEENAME: MelvinTGydesen RECEIVED <br />PERMIT NO.: M-1982-020 MAY 17 2001 <br />OPERATION NAME: Lucky Strike Lode <br />pivision of Minerals and Geology <br />ANNIVERSARY DATE: May 25, 2001 <br />ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br />COUNTY: Gunnison <br />~' <br />VY <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />-- -land,-reclamation-ascemplished to date and-during-the preceding-year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual resort mau to this form. Please note thnt an <br />ade9uately Icrbeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Melvin R. Gydesen <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />MelvinTGydesen <br />229 CR 11, Space No. 21 <br />Gunnison, CO 81230 <br />(970)641-2399 <br />9To-G Y ! --5~ ~3 <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 Re ort instructio~7ns are <br />enclosed. ~ ~~l) ~ ~ `%~ a~tY ~~ <br />~~--- ~ ~~~ ,~, NCO / ~-~~ `~~ <br />Signature of Corporate ficer or Owner `~Z~~~/~~ ,'~~~ <br />Date ~CC~-~-6 ~R/.LC.w~Y i,>'"" _ `^'j <br />M.~PERMITMASTERDOCUMENTS/M~AF-0?.DOC v ` ~ ~-/%Z~~~ <br />