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~ III IIIIIIIIIIIIIIII ~ ~ ~~ <br />999 ~~~ ~I <br />ANNUAL KN:YVxr ~ +.:~ <br />RECEIVED <br />PERMITTEE NAME: Malouff Construction Inc. (~ <br />PERMIT NO.: M-82-033 ~i,r ~ ~, 'IJJ.7 <br />OPERATION NAME: MalouffPit pivisionolMinerals&GeologY <br />ANNIVERSARY DATE: October 08,.1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Conejos <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />- operator-shall submit-[he annual fee, a report and-map-showing-the-extent of current disturbances -- - -- - <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note drat un adequately labeled map that clearly delineates and <br />includes the nbove elements may suffice for a written report. n0 ~~ ~ ~(j'` <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: ~ ~ Company: )~~ <br />Addr s: Q Phone No.: C,1 - ~ <br />~. ' Fax No.: ( 7I ~ 1 ~ 0 ~ ~L2~ <br />If [here are additional comments and/or infotma[ion that should be provided [o [he Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />Date <br />INSTRUCTIONS ON BACK <br />~vrittan rPnnrt <br />