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RECEIVED <br />ANNUAL FEE and REPORT REQUEST <br />APR 2 3 2002 <br /> <br />Division of Minerals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Killion Supply <br />M-1985-184 <br />Killion Supply <br />February 18, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Latimer <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 showing the extent of current disturbances to affected land, <br />---'reclamation accomplished"to date and during the preceding year, new distutbuuce~"thar are anticipated ro'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 />ch your revised written annual report and annual report map to this focm-Ptease note that an <br />labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jamie Killion <br />Permittee Name: Killion Supply <br />Address: 862 W. Wilcox Ln. <br />Ft. Collins, CO 80524 <br />Phone Number: (970). 482-0358 <br />.r _ Eax_Number:- _ _ _ (9.7.0) 221 =1626, . _ _ <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 enclosed. <br />{'til. n- - <br />Sig tore of Corporate Officer or Owner <br />~-31-02 <br />Date <br />M:IPERM ITMASTERDOCUM EMSU~I-AF-OI <br />