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NOV-19-02 10:12 FROM-Colorado Divisimt of IAinerals & Geoloay +)3038663567 <br />'/ <br />T-658 P.003/003 F-223 <br />REIr+~@ V CD <br />NOV 2 1 2002 <br />PERMtITEE NAME: Crai1 C. ADen mtd Millie J- A11en <br />FERMiT NO.: M-2000-OSO <br />OPERATION NAME: Broken Spear Pit <br />.ANNIVERSARY DATE: October 2, 2002 <br />Division of Minerals and Geology <br />ANNUAf. FEE DUE: - - ~ _ _ _ . _ $281.00 (Due on or before yonr anniversary date) <br />COUNTY: <br />Lincoln <br />According to C.R.S_ 3432.5-116 or C.RS. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall suburit the annoy] fee, a report and tvap showing the extra[ of current disturbances to affected land, <br />teclatnation accomplished to date and during the preceding yeaz, new disturbances thaz are anticipated to occur <br />during the upcoming yeaz, reclamation thaz will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the yeaz. if any. <br />Please atach ~rc revicerl written :animal rrp.~tt and anmral rennrr mao to rhic farm- PleaSr note [liar an <br />adequately labeled map that clearly delineate; and incluAes the above elemanz.r Wray sr~ce for a written reparr. <br />Division records indicate the following pertnittee contact information. Please verify and make arty necessary <br />changes <br />Pernnnee Comazt: Gail C. Allen <br />Perini[tee Nattte_ Gail C. Allen and Millie J. Allen <br />Address: 68073 CR 109 <br />Genoa, CO 30818 <br />Phony Number: (719) 163-2305 <br />Fax Number- Crllk~ ]raj-a3p~ <br />If you have additional continents aud/or information [hat should be provided to the Division, please provide it <br />below or attach i[ to this form along with your written report and map. Annual Report instructions are enclosed- <br />~~ ~~ <br />Std~ttature of Corporate Officer, Owner, or Desie ee <br />1~~/uy <br />T,. <br />llate <br />MN'fkMrtlMnSTEFUO~UML`rrsUl-wf-0, <br />