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f. <br />~•~. • III IIIIIIIII IIII III ~ i fi <br />ANNUAL FEE and REPORT REQUEST ',r <br />-~ <br />PERMITTEE NAME: United Companies of Mesa County, Inc. RECEIVE p <br />PERMIT NO.: M-1994-005 MAY p <br />OPERATION NAME: Coloua Gravel Pit ' 2001 <br />ANNNERSARY DATE: May 6, 2001 Ui~ts'an of Minerals and Geaingy <br />ANNUAL FEE DUE: $550.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, 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 vour revised written annual reaort.and annual report maa to this form. Please note that an <br />adequately lnbeled rnap that clearly delineates and includes [he above elements Wray suffrce 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: -RauLE_A4s6ehea ~~..a..~ Jo~~.sorl <br />Permittee Name: United Companies of Mesa County, Inc. <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. Annual Report instructions are <br />enclosed. <br />~µ ~l'~t - I CQ -/~~SIC1[ ~~ <br />Signature of Co ate Officer or Owner <br />G~/~loo~ <br />Date <br />M:~PERMITMASTERD000AfE NTSUI-AF-01 <br />