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S~ <br />.~/ ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: v Tri County Gravel ~ ~ ~ ~ ~ ~ /~' <br />PERMIT NO.: % M-1977-205 .v ~~T ~ Q Z0~6 <br />OPERATION NAME: Tri-County Gravel /Division of Reclamation, <br />ANNNERSARY DATE: November 29, 2006 Mining and Safety <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Delta <br />rvli5/Z- <br />/o -i3 -oG~ <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 />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 report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />ma . If no new disturbances or reclamation have occurred during the previous veer and no new chances to <br />the previous year's map are necessary. then no new map is required, provided that the Operator shall state <br />this in the Anneal Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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 E. Curry <br />Permittee Name: Tri County Gravel <br />Address: P.O. Box 566 <br />Hotchkiss, CO 814(9 <br />Phone Number: <br />Fax Number: <br />(970) 872-3545 <br />(970) 872-3792 <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 farm along with your written report and map. Annual Report instructions are enclosed. <br />n D '~ <br />y1'1 an..rCi~ d (.UJ~J-~-r~- <br />Signature of Corporal Officer, Owner, or Designee <br />G <br />Date <br />