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1 . <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST~ EC E ~ V E <br />MAYA 2 7~9? <br />r ~' <br />Yuma County JUN 0 6 2002 <br />M-1981-179 pivision of Minerals and Geology <br />Mekelburg Pit No 1 <br />June 30, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Yuma <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 your revised written annual report and annual report map to this form. 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: Paul Like <br />Permi[tee Name: Yuma County <br />Address: ] 310 S. Blake St. <br />Phone Number: <br />Fax Number: <br />Wray, CO 80758 <br />(970)332-5718 <br />(970) 332-3429 <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 instmctions are <br />enclosed. <br />Signature of Corporate Officer or Owner <br />~ ~l S ~ 6~ <br />Date <br />M:V'ERMnN1ASTERD000MENTSVv1-AF-M <br />