2001-04-19_REPORT - M1989044

• Permit No: M1989044
• IBM Index Class Name: Report
• Doc Date: 4/19/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

999
ANNUAL FEE and REPORT REQUEST
~~
RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
The Clare Corporation
M-1989-044
Twin Crk Campground
April ] 0, 2001
APR 19 2001
Division of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Teller
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 shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur durinE; the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning ot~active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual resort matt to this form. Please note that an
adequately inbeled n:ap that clearly delineates and includes the above elements may suJfrce jar a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Harold E. Clare, II
Permittee Name: The Clare Corporation
Address: P.O. Box 1
Florissant, CO 80816
Phone Number: [phone]
Fax Number: [phone]
If you have +tdditional comments and/or information that should be provided to the Division, please provide it
below or attach i[ to [his form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Corporate Officer or Owner
Date r
M:\PERMn V.1ASTf ~.RD000 MENTSNI-AF-01