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~ iiiiiiiiiiiiiiii~~i , <br />ANNUAL REPORT <br />~E~E~v~o <br />PERMffTEE NAME: I{iowa County ~ ZO~~ <br />PERMPf NO.: M-1991-078 ~pN 1 ~` &Geo~o9y <br />OPERATION NAME: Peters Pit ) ~o`M~t~ <br />ANNNERSARY DATE: February 4, 2000 'y16~ ~wsto <br />ANNUAL FEE DUE ON ANNNERSARY DA $zZ5.00 <br />COUNTY: Crowley <br />According to C.R.S. 34-32-116(3)(a), 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 <br />to affected land, reclamation accomplished to date and during [he preceding year, new <br />disturbances that are 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 the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual report. <br />Please note that ar: adequately [nbeled map that clearly delineates and includes the above <br />elements mny since for a written report. <br />Please t}~pe or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Cunt:at \:Imc: Rick Spady <br />Address: Kiowa County <br />PO Box 100 <br />Eads. CO 81 <br />Cc~lnp:ut}: Kiowa County <br />Phone No.: ( 719 ) 438-5810 <br />FAX No.: ( 719) 438-5327 <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach i[ to this report form along with your map and/or <br />written report. <br />If <br />~ignatun° o orp to Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />M iPERMRW7ASTI:RD000MENfSNA~AF-b/ <br />