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<br /> <br />RECEIVED <br />JUL f 12003 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Sutherland Brothers, Inc. <br />M-1996-031 <br />Weimer No. 2 <br />July 2, 2003 <br />Division of Minerals and Geology <br />$281.00 (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-I 16, 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 disturbances that are anticipated to occur <br />during the upcomirig'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 />Please attach ynnr revised written anneal re~nrt and anneal re nn rt main to this form- Please note that an <br />adequately labeled map that clearly delineates and inc/udes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pennittee Contact: Bob Sutherland <br />Permittee Name: Sutherland Brothers, Inc. <br />Address: 29703 Hwy. 97 <br />Phone Number: <br />P.O. Box 889 <br />Nucla, CO 81424 <br />(970)864-7662 <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 />(~~ ~,~ - <br />Signature of orporate Officer, Owner, or Designee <br />c ~~~, <br />Date <br />M:\PERMnVNASTERDOCUMENTS\M-AF-O7 <br />