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v ?- <br />ol b Z <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL' FREQUEST <br />985-029 <br />Alma Placer Mine <br />4L] 2 2 201.. <br />Division of Reclamation, <br />Mining & Safety <br />February 22, 2010 <br />$$633.00 (Due on or before your anniversary date) <br />Park <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 <br />- - operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />-- - <br />- - -- <br />land, reclamation accomplished to date -- and during-the preceding year,-riew disturbances that are-anticipate to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />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: Patti 0"eamffmn <br />Permittee Name: 1- <br />Address: P.n l <br />M of nn 20122 <br />Phone Number: ffI9) 48i-22? 3,3- /bL- `1- ! 7? <br />Fax Number: -119) 48` -2277 3z23- 7e!-"1- `7 <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 <br />enclos <br />,. of Corporate Officer, Ay6er, or Desig ee <br />Signa(ur <br />Date <br />M: \PERMIT\MASTERDOC UA4:ENTS/M-AF-02.DOC