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<br />RECEIVED <br />JUN 2 3 2003 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Russell D Newham <br />M-1977-500-UG <br />Peggie Mines <br />June 29, 2003 <br />Division •f Minerals and Geology <br />$225.00 (Due on or before your anniversary date) <br />Montrose <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 />and, rec amatton accomp is a to ate an wring 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 ynnr revised written annual rennrt and anm~al re~nrt mad to this form- Please not¢ that an <br />adequately labeled 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: Russell D. Newham <br />Permittee Name: Russell D Newham <br />Address: P.O. Box 67 <br />Fax Number: <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 <br />enclosed. <br />Signature of Co~r/p~orate~tOff~icer, Owner, or Designee <br />/~//mv_ / 'T i ~-~7 <br />Date <br />Naturita, CO 81422 <br />P e~ ~~ .~ _~ 14- <br />Nu~l~~ G6- A/¢Z~ <br />M:~PERMITVNASTERD000M ENTS~M-AF-02. DOC <br />