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ANNUAL FEE and REPORT REQUEST <br />AUG 0 2 '2001 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Sandco, Inc. <br />M-1986-165 <br />Willow Bend <br />August 27, 2002 <br />RECErvE~ <br />Division of Minerals and Geology <br />Minerals and <br />$281.00 (Due on or before your anniversary date) <br />La Plata <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, 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 land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during [he coming year, the dates for [he beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sr ffce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David D. Dillon <br />Permittee Name: Sandco, Inc. <br />Address: P.O. Box 4440 <br />Durango, CO 81301 <br />Phone Number: (970) 247-1303 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />beloyv or attach it to this form along with your written report and map. Annual Report instmctions are enclosed. <br />Signature of Corporate Officer or Owner <br />Date <br />M:V'r:Rh11T4M ASf HR DOCU M HN"rSVN-AP-II I <br />