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NIP 9- Rp T <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />ell- <br />Mine Development Inc <br />/ M-1981-165 <br />Neglected Mine <br />October 2, 2010 <br />$259.00 (Due on or before your anniversary date) <br />La Plata <br />RECEIVED <br />v/ OCT 072010 <br />L- Division of Reclamation. <br />Mining & 5afa <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 />-_ e.?no +?, l+oll enl+tn+t tha?nniial_fPPy a rp r? an man chpyyj]Zg.th . .x .n of cLlrrent-disturbances to-affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated 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 vour revised written annual report and annual report may 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 vear'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: Harold E. Luzar <br />Permittee Name: Mine Development Inc <br />Address: 3319 E 4th Ave <br />Durango, CO 81301 <br />Phone Number: (970) 247-1652 <br />Fax Number: (no raje, <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 />enclosed. <br />Signature of Corpor ce , Owner, or Designee <br />Date <br />M:\PERMIT\MASTERDOCUMENTS/M-AF-02.DOC