2001-10-09_REPORT - M1978091UG

• Permit No: M1978091UG
• IBM Index Class Name: Report
• Doc Date: 10/9/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

. 999
RECEIVED
ANNUAL FEE and REPORT REOUEST OCT U 9 2001
PERMITT'EE NAME: LKA International Inc. Division of Minerals and Geology
PERMIT NO.: M-1978-091-UG
OPERATION NAME: Golden Wonder Mine
ANNIVERSARY DATE: October 1, 2001
ANNUAL FEE DUE: $450.00(Due on or before your anniversary date)
COUNTY: Hinsdale
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 shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adequately labeled snap that clearly delineates and includes the above elements may, suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Lance Barker
Permittee Name: LKA International Inc.
Address: P. O. Box 821
Lake City,CO 81235
Phone Number: [phone]
�Fax Number. [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclose
k-L'
Si acute of Corporate Officer or Owner
col
Date
MVERMIPMASTERDOCUMENTS/M-AF02 DOC