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<br />~ III IIIIIIIIIIIIIIII ~ <br />^l-G~tVED <br />ANNUAL REPORT <br />DEC 2 U 1999 <br />PERMITTEE NAME: Adams County ~-~ is~onolMinerah&GeoWgy <br />. ~n... <br />PERMIT NO.: M-77-283 ~ <br />OPERATION NAME: Debetz Pit ~ <br />ANNNERSARY DATE: December 21, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Adams <br />According to C.R.S. 34-32.5-1 l6(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 are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ce.3sed for the year, <br />if any. <br />Please attach your revised annual report map and written resort to this annual r~:pOrt. Please <br />note that an adequately labeled map that clearly delineates and includes the above elerne~tts mny <br />suj~iceJora 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: ~^'~t~t I ES5~1l~f`. Company: /k,'~~htit~, ~c,ve 1~ <br />Adddress: 4~ /SS t~ l4 ~ l~-t-~ _ Phone No.: (hc'~) ~=`> > - ~c) <br />i7 <br />~,~~Idtd~~Gr/ L' i l~ ly ~L`712'~ Fax No.: (?03) -sS s ~- 7U. ~ <br />If there are additional comments and/or infotmation That should be provided to the Division, please <br />provide it on a separate sheet and attach it [o [his report form along with your map and.'or written <br />report. <br />r--~l~t~r~c'O il~~crr~~t` /l~~'Fk~S~ 11 ~3 <br />Signature of Corporate Officer, or Owner Date <br />/NSTRUCTIONS ON BACK <br />