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<br />RECEIVE® <br />G~0~ 10 200 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />West End Gravel Company, Inc. <br />M-2001-002 <br />Weimer One Gravel <br />September 12, 2003 <br />t)ivistOn of Minerals & 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 the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />accomplished-to-date-and-during~h rtarbatrees-drat~re'antioipaFed-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 attarh ymm revised written anneal red nrt and anneal rennrt mat 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: Bob Sutherland <br />Permittee Name: West End Gravel Company, Inc. <br />Address: 29703 Hwy. CO-97 <br />P.O. Box 848 <br />Nucla, CO 81424 <br />Phone Number: <br />Fax Number: <br />(970)864-2177 <br />(970)864-7980 <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 />--~~~ ~/~ <br />Signature of Corporate Officer, Owner, or Designee <br />1/-~-~~ <br />Dale <br />M:~PERMITV.IASTERD000MENTSV.7-AF-01 <br />