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1 <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Dilleys Saud & Gravel <br />M-1986-105 <br />Vondy Pit <br />August 29, 2003 <br />$281.00 (Due on or before your anniversary date) <br />Morgan <br />AUG 1 ~ 2003 <br />Division ~t Minerals and Geology <br />According to C.R.S. 34-32.5-] 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annua Cee, a rep~o~-iriap s owr-h - ng t tt e extent o 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 ynnr revised wri ten ann gal r yyart and anneal renart m ~n 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: Vemon Dilley <br />Permittee Name: Dilleys Sand & Gravel <br />Address: 1914 Edmunds St. <br />P.O. Box 125 <br />Brush, CO 80723 <br />-____Phone_L~lumberr_-(9-7Q)_R42-2810-- - <br />Fax Number: (970) 842-2284 <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 repor((t~~and map. Annual Report instructions are enclosed. <br />4t/~Ly aaa3.a,~-e- ~u-e, ~dTt~2, •eJ <br />gnature of Corporate Officer, ner, or Designee u-~-n'i. .~-~-U (/,~~~ <br />/~ a`3 <br />Date <br />M:~PERMITMASTERDOCUMENTSN-I-AF-01 <br />~y.Gy(~ ~J~-Q-O <br /> <br />