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• • <br />ANNUAL REPORT <br /> <br />PERIvIITTEE NAME: James VanElla <br />PERMIT NO.: M-92-045 <br />OPERATION NAME: Gold Basin Mine* <br />ANNIVERSARY DATE: July 21, 1999 ,, <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 //°„",..~_~Y`_' %/ ° ~ <br />COUNTY: Chaffee ~G~ 0 <br />- - According to C:K"SS 34-32-116(3)(a), each yeaY, on the anniversary' date of'the pemut; ah - <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished [o date and during they preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please Mote that mi ndegnately labeled map that clearly delineates and <br />includes the above elements mny suffice for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Company: /[rOn.P <br />Phone No.: (~/9) 6~i~~~.®~~ <br />Fax No.: <br />If there are additional comments and/or information that should he provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />ignal.ure of Corporate Officer, or Ow~r Date / <br />INSTRUCTIONS ON BACK <br />