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RECEIVED <br />1'I•.1(MI'I-fG8 NAi111'.: 'I'mtn of Limon <br />rl•IC~1rr ~<).: ~I-Inez-w~ MAR 2 31006 <br />O1'h.K:\I1ON NAb1G: 1'ath''s 1'it o~. .,, • ,, ,~.I:.,eG.m~~yv <br />ANNIVI•:RSARY' I):\'I'li: April Itl, 2000 <br />ANNU;V. I'I•.P: U1'I{: $2x1.110 (Uur on or before your anniaertary dote) <br /> <br />:lccording to ('. K.S. 1d-?2.$-1 IO or <'.R.S. ~4-i?-I I0, each year, on the annnrrsary date of the permit. an <br />opcmtur .hall submit the annual Ice, a report and map showing the extent of current drsturhanccs to atlcclcd <br />land, rcclamanon accumplr.hcd to date and dunng the preceding year, nett disturbantrs That arc ;uvitipatrd a, <br />occur dunng the ulttomtnc year', reclantanon Ih;d tall ht Ix•rli+ntxd dunng Ihr tonnng year. tht date, tin- the <br />hct!mnutp of arhtr opemuun,. and Ihr d;dc acuae uperuLon. eea,ed ti+r ;lie rear. tl ant, <br />1'Ientc nttach tour rectcrd ttridt•n .nn ,sl rnport ~ nd rnr~ryl+nrt m>_It [n thi. fn nu Pl+•+rxe rrotr rho( un <br />+ut<•r~u+uvA /,nc~l~~l mop rhur r/rur/r drliar+u,•+ wrJ im lruh:+ rhr uhnrr rAmrrttcv rmn .v'u~Jirr Jor a wriurn <br />rtpurr, <br />biatsion record, mdicatr the following pcrmittce contact mfixmuwn. !'lease vrnfy and ntakc any necessary <br />changes: <br />I'rrmittrr ('ontact: Ihtce Stone <br />PcrmittceNumr: 'I'owno(Limvn <br />Address: P.<). 13ox 9 <br />Limon, CO xOx2x <br />I'hunc Numhrr. (71'11 ?y+-? id0 <br />Pax Numhrr: 7/Q "l7S- 9079 <br />II you hate additional Comments ant1~'or intotmation that shoulJ be provided to the I)it•tsion, please provide it <br />below ur attach rt to this lomt along with your written report anJ map. Annual Report instmctions are <br />enclosed. <br />--~~~~ ~~ <br />Signature of Corpomtc O(liter. Owner. or I)rstgnee <br />3~zi /o ~ <br />Uar. <br />