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e ~ <br />ANNUAL FEE and REPORT REQUEST <br />L~:. <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />United Companies of Mesa County, Inc. <br />M-1994-005 <br />Colona Gravel Pit <br />May 6, 2002 <br /> <br />RECE~~ED m <br />MAY 0 6 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Montrose <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of [he permit, an operator <br />__ ~_ _ shall_submit_the_ annual_fee,_a_report, and, map showing the extent_of current_disturbances_to_affected_land,.__ <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 vour revised written annual report and annual reuort 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 report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Richard Johnson <br />Permittee Name: United Companies of Mesa County, Inc. us ~er~.~a.....4.,-~•rs oC (vxPSrti C~a.~~ <br />Address: P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5945 <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. Annua] Report instructions are enclosed. <br />~~~i ~ VV V <br />Signature of Corporate Officer or Owner <br />~~a-~o~ <br />Date <br />M9PF.RMmMASTERDOCUMENTSVN-AF-O ~ <br />