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• <br />PERMITTEE NAME: Glen Johnston <br />PERMIT NO.: M-1982-044 <br /> <br />ANNUAL REPORT <br />OPERATION NAME: Glen Johnston Site 1 <br />ANNNERSARY DATE: April 23, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 <br />COUNTY: Teller <br />• <br />7°t9~i+D <br />cFR ~~ ~d~ <br />,;,eiet~~'~ <br />~~~,~ <br />Acccrding [c C.R.S. 34-32-k l6(3)(x},-each year, on the anniversary date of the permit,-an operator shall <br />submit the annual fee, a repots and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated <br />to occur during the upcoming yeaz, reclamation that will be performed during the coming year, [he <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report maa and written report to this annual resort. Please <br />note tluit mt adequately labeled rnap shut clearly delineates and includes the above elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: l <br />PPS,^.y ~C'(' f~ ~~nNS'~'~-- <br />Contact Name:,~N ~o/1,vSTo n/ Company: 11~ -~ ~ ~ ' ~ 6`{ ~ <br />Address: i3iG ~oGA.d <br />Phone No.: ( 7/ 9 1 c~7s - /90?~ <br />FAX No.: ( ) <br />~~' ~' ~~~ <br />If there are additional comments and/or information that should be provided to [he Division, please <br />provide it on a separate sheet and attach i[ to this report form along with your map and/or written <br />report. <br />_~~ ~~ <br />Signature o Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />h11PERMaN1ASTER DDCUM ENTSUI-AF-01 <br />