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<br />C~~D ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />J-Rode, Inc. <br />M-1989-009 <br />J-Rude Inc <br />March 17, 2004 <br />$281.00 (Due on or before your anniversary date) <br />Prowers <br />RECEIVED <br />MAR 16 2004 <br />Division o!.@„ .[... `': <br />~1~OI0~ <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 />recla'rimiionrucoomplished to-date-and-during-the-prECeding_year, new.disturbances_t~t are anticipated to occur <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 y~~r revised written annual reynnrt and annual re~nrt main to this form- 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: Rudy Torres <br />Permittee Name: J-Rude, Inc. <br />Address: 1750 CR HH <br />Phone Number: <br />Fax Number: <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 enclosed. <br />C~/U,~L <br />Signa off ~ ra/te Officer, Owner, or Designee <br />~1/D~D ~f <br />Date <br />Lamar, CO 81052 <br />(719) 336-7361 <br />