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~ ~ ~ _: _: <br />ANNTIAT, FF.F. and RF.PnRT RF.OiTFST <br />PERMITTEE NAME: Warren & Sally Wilcox dba Gunnison Gravel &Earthmoving <br />PERMIT NO.; M-1978-305 <br />OPERATION NAME: Dickerson Pit <br />ANNIVERSARY DATE: February 22, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Gunnison <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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />hcd-to-data~ad-during-tlre-preceding-yeas-~~.w-dish~rbartc;es-tbs~are.antiC~d_fo_oc&uL <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written annnal rein and anm~al report man to this fnrm_ Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Warren Wilcox <br />Permittee Name: Warren & Sally Wilcox dba Gunnison Gravel & Earthmoving <br />Address: P.O. Box 42 <br />Phone Number: <br />Fax Number: <br />Gunnison, CO 81230 <br />(970)641-3088 <br />(970)641-5811 <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 ~s form along with your writte report and map. Annual Report instructions are enclosed. <br />• ~~~ ~~ ~ <br />9~ tore of Co o to icer, caner, or Des ee <br />j--~-~.~ <br />Date <br />