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•Y. Y <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Bent County <br />M-1985-014 <br />Bonnie Earl Pit <br />April 12, 2002 <br />RECEl~OEp <br />APR 15 2002 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Bent <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, 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 to affected <br />-- - - land;-reclamation-accornplished-CO date-and during the prece8in'a year, new dismrbances that are anticipated [ti - "- - <br />occur during the upcoming year, reclamation that will be performed during the coming year, [he dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual resort and annual resort map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact. Gary Pritchard <br />Permittee Name: Bent County <br />Address: P.O. Box 350 <br />Las Animas, CO 81054-0350 <br />Phone Number: (719) 456-2223 <br />Fax Number: (719) '1t5 [o - 0 3'7s <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ [o this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signatur f Corporate Officer or Owner <br />~ii+PRc~ ~-/ ~ oo Z <br />Date <br />M:~PERM17N1ASTERD000MENTSUr-AF-04 <br />