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v~ <br />iii iiiiiiiiiiiiiiii • ~ <br />1 <br />ANNUAL REPORT <br />PERMITTEE NAME: L.G. Everist Inc. <br />PERMIT NO.: M-96-049 gECEIVED <br />OPERATION NAME: Maryland Creek Ranch SEC 17 1999 <br />ANNNERSARY DATE: December 20, 1999 <br />,;en of MineraM~ ~ G80~Y <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Summit <br />According to C.R.S. 34-32.5-116(3)(a), 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that aze <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />yeaz, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report man and written report to this annual report. Please <br />note that nn ndequntely labeled map that clearly delineates and includes tl:e above elements nrny <br />suffice for « written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: ~- yNN M ILYGl2_pp Company: ~ • ~ ~ ~ U~ I ST ~/NC- . <br />Adddress: 73Z I E. $~`"''AvF UUtrE Z0~ Phone No.: 4%03) Z87- 1/(iS (o <br />~H~tt~~au. GO g0(~/D Fax No.: 430.x- 2$9- 1,3y$ <br />If there aze additional comments and/or information that should be provided to the Division, please <br />provide it on a sepazate sheet and attach it to this report form along with your map and/or written <br />report. <br />~ ~z~/~ <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />