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RECEI "~~ <br />9r~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Mountain Region Corporation <br />M-1995-005 <br />Orchard Mesa Aggr <br />February 16, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />FEB 2 3 2006 <br />Division of Miner,. .k <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 />reclamation accomplished to date and during the preceding year, new disturbances that 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 xpur revised written anneal report and anm~al re~Drt main, to this form. please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since far a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Sandra R. DuCray <br />Permittee Name: Mountain Region Corporation <br />Address: 117 - 29 3/4 Rd. <br /> Grand Junction, CO 81503 <br />Phone Number: (303) 242-5461 <br />Fax Number: (970) 242-6728 <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 />Signature of Corporate Offic •, Owner, or Designee <br />_ ~ ~/u /~ ~ <br />Date <br />