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~~~ <br /> '~ )~ ~/ <br /> ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: ~ Indian Springs Mining <br />PERMIT NO.: ~M-1981-020 <br />OPERATION NAME: Thorsen Mine <br />ANNIVERSARY DATE: May 6, 2008 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br />~~~~~ <br />APR 15 2000 <br />"vision of Keclamation, <br />Mmmg and Safety <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 />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <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. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durinS the previous year and no new changes to <br />the previous year's man are necessary. then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suffice for a written report. <br />Division records indicate the followin permittee contact information. Please verify and make any necessary <br />changes: ~(/'~ dl~~ ~~/~~G--~S ~C.~~ 1'Yf t'I ~ D~ ~/ L-~ /S S % %~- ~il,~~.~ <br />~'v4d ~~5,- ~ ~~ i~ v2vv'7. <br />Permittee Contact: Carlina Henry <br />Permittee Name: Indian Springs Mining <br />Address: 3257 CR 67 <br />Penrose, CO 81240 <br />Phone Number: (719) 372-3907 <br />Fax Number: ~! <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 />~~ <br />Signature of Corporate Officer, Owner, or signee <br />~,i~~~ <br />Date <br />