REP00016 ‎(2)‎

III IIIIIIIIIIIIIIII
ANNUAL REPORT
PERMITTEE NAME: Weld County
PERMIT NO.: M -87 -186 RECEIVED
OPERATION NAME: Peters Pit No 2* FEB 17 1999
ANNIVERSARY DATE: March 01, 1999 `ivision of minerals & Geolow
ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00
COUNTY: Weld
In order to ensure that our records are up to date, please attach your revised annual report map and written
report to this annual report. Note that a written report is not necessary if the map addresses all the
items listed in the attached instructions concerning mining disturbance and reclamation update.
Please type or print the current contact person's name, mailing address, and phone number in the space
provided: /�
.Contact Name: 0k.. k Lin l Company: V /�1d �� R d 1,� y /ork9
j
Address:: Po Arix 751T Phone No.: (97D) 356, —y4un Y 375 cj
).,I �c, �1Y�3� Fax No.: ( 97n
.. . .
Signature of Corporate Officer, or Owner
. M ADNRMLNIASTERDN1- AF -Pt.
it /9
Date