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99 <br /> _ANNUAL FEE and REPORT REQUEST <br /> RECEIVED <br /> PERMITTEE NAME: Yuma County JUN 0 12001 <br /> PERMIT NO.: M-1981-254 <br /> OPERATION NAME: Collette Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: June 30,2001 <br /> ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br /> COUNTY: 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?rote that an <br /> adequately labeled map that clearly delineates and includes the above elements pray 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: Rich Brown Paul Like <br /> Permittee Name: Yuma County <br /> Address: 1310 S. Blake St. <br /> Wray, CO 80758 <br /> Phone Number: (970)332-5718 <br /> Fax Number: (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 instructions are <br /> enclosed. <br /> E� 67� <br /> Signature of Corporate Officer or Owner <br /> 5-31-01 <br /> Date <br /> M\PERMITMASTERDOCUti¢NTSN7-AF-04 <br />