2006-10-13_REPORT - M1990114

• Permit No: M1990114
• IBM Index Class Name: Report
• Doc Date: 10/13/2006
• Doc Name: Annual Fee/Report/Map
• From: Saguache County
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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+~ ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Saguache County
~M-1990-114
Noland Gulch
October 26, 2006
s N~~
lG ~'~~eb
RECE~~E~
`~ocr ~ ~ ~Qpg
~visron of ReelIIifl~(®ry~
Mining arai ggl~,
$688.00 (Due on or before your anniversary date)
Saguache
____ According_to-C.R.S. 34-32.5-116-oE-G.R.S.-34-32-1-16,-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
]and, reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual resort mau to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated man. If no new disturbances or reclamation have occurred durinc the urevious year and no
new chances to the previous year's map are necessary. then no new mau is required, provided that the
Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly
delineates and inclzzdes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Petmittee Contact: Randal Anedondo
Petmittee Name:
Address:
Saguache County
P.O. Box 476
Saguache, CO 81149
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclo
Si ature of Corporate Officer, Owner, or Designee
La-~o-~
Date
M:IPERMI'MIASTERDOCUMEMNN-AF-04