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._ / <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Nikolaus Arnusch <br />M-1981-287 <br />Arnusch Grav Pit 3 <br />February 25,2003 <br />$281.00 (Due on or before your anniversary date) <br />Weld <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 />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to 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 />please attach your revised written anneal rennrt and anneal report m ~n to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Petmittee Contact: Nik Arnusch <br />Permittee Name: Nikolaus Arnusch <br />Address: 34527 WCR 6 <br />Keenesburg, CO 80643 <br />_._ _-=PhonerNumber:~ -x(303) 732-4427 _ _ . _ ___.._ _ _ <br />Fax Number: <br />-~ ~(Ll tfA-m ~'~s <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 />i~ r ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />~~ ~~ o~~ <br />Date <br />RECEIVED <br />FEB 1 4 2003 <br />Division of Minerals and Geology <br />MIPERMITMASTERDOCUMENTSUI-AF-01 <br />