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'~. ~ ~ IIIIIIIIIIIIIIIIIII <br />ANNUAL REPORT <br />PERMITTEE NAME: Logan County <br />PERMIT NO.: M-78-249 <br />OPERATION NAME: Melvin Kokes Pit <br />ANNNERSARY DATE: October Ol, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Logan <br />RECE-°/'~~' <br />MAR U 8 2000 <br />Divisicn of nlinetaF ~~ ~--,.'yl~ <br />According to C.R.S. 34-32-I 16(3)(a), each yeaz, on the anniversary date of the permit, an <br />operator shall submit the 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 aze 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 [he 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 that an adeyuntely labeled map thnt clearly delineates and <br />includes the above elements mny sake for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: IC.2.r, ~tr0 ~~ 2h <br />A/dd1ress: ~ ~ S ~ Gl. r ti ~ f~'e-Q-~" <br />'71iQ..r~~ r~r ~~ 075/ <br />Company: L.O f CL-1~.~ ~ ~ I.ti l'ti d~-r <br />Phone No.: (Q 70 ) ~~ ~-~ - d ~Q g O <br />FaxNo.:(G7d ) Saa-yol ~ <br />If [here are additional comments and/or information that should be provided to the Division, <br />please provide i[ on a sepazate sheet and attach i[ to this report form along with your map and/or <br />written report. <br />~ ~~0 <br />ignature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />