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d~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Montrose County <br />M-1983-148 <br />Neal Pit <br />January 30, 2004 <br />$688.00 (Due on or before your anniversary date) <br />Montrose -~ <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-aecomplished-to-date and•dnring-ihe-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 anmial report and annnal rennrt m ~n to this Snrm- please note thal an <br />adequately labeled map that clearly delineates and includes the above elements may suffce 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: Brian Wilson <br />Permittee Name: Montrose County <br />Address: 161 S. Townsend <br />Montrose, CO 81401 <br />Fax Number: (970) 249-6680 <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 />RECEIVED <br />~~ 15 2004 <br />re of Corporate Officer, Owner, or Designee <br />41rim~ of Minerals & Geology <br />I~r 2Z ~u'? <br />Date <br />M:\PERMITVv1ASTERD000MENTSUA-AF-04 <br />