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~~ ~. ..x`_'. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Cecil C Powell <br />M-1995-012 <br />Powell's Gravel Pit <br />May 12, 2002 <br />~- <br />RECEIVED <br />MAY 2 8 2002 <br />Dlolsion of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Moffat <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=raport~and-map showing-the-exten'.-.of current=disturbances~to-aff@cted-°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 your revised written annual report and annual report map to this form. Please note that an <br />kdequately 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: Cecil C. Powell <br />Permittee Name: Cecil C Powell <br />Address: P.O. Box 23 <br />Phone Number: <br />Fax Number: <br />Dinosaur, CO 81610 <br />(970)374-2329 <br />This information is correct. <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 instmctions are enclosed. <br />Signature of Corporate Officer or n~~ ~~ __ <br />Date 5/15/02 <br />M: W ERMITVNASTERDOCUMENTSN4-AF-01 <br />