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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />EI Paso Couuty <br />M-1980-189 <br />Yoder <br />October 23, 2003 <br />$281.00 (Due on or before your anniversary date) <br />EI Paso <br />RECEIVED <br />ocr~s~ <br />Division of Minerals and Geology <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 <br />operator 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 anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ymrr revised written anmlal rennrt and annnal rennrt main to this Tnrm_ 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: George P. Sugars <br />Permittee Name: El Paso County <br />Address: 3460 N. Marksheffel Rd. <br /> Colorado Springs, CO 80922 <br />Phone Number: (719) 520-6860 <br />Fax Number: (719) 520-6878 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />of Corporate Officer, Owner, or Designee <br />2 9/~~ <br />Date <br />M:~PERMITUTASTERDOCUMENTSU1-AF-09 <br />