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\~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />D Aun Mangus and LaTonne Mangus <br />M-1978-221 <br />K-Bar-T Pit <br />August 23, 2002 <br />RECErv~o <br />JUL 2 2 2002 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Rio Blanco <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 annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes 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 />'Permittee Contact: D Aun Mangus <br />Permittee Name: D Aun Mangus and LaTonne Mangus <br />Address: 4160 CR 8 <br />Phone Number: <br />Fax Number: <br />Meeker, CO 81641 <br />(970)878-0737 <br />(970)878-0738 <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 />l <br />Signature of Corporate Of er or Owner <br />7-~ -oa <br />Date <br />M:NERMnw1ASTERD000MENT5Vv1-AF-OI <br />