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t • III IIIIIIIIIIIII III • <br /> 999 <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> PERMITTEE NAME: Wyatt Redi-Mix Co AUG 0 6 2001 <br /> PERMIT NO.: M-1997-039 Division of Minerals and Geology <br /> OPERATION NAME: Williams/Illinois Gravel Pit <br /> ANNIVERSARY DATE: August 12,2001 <br /> ANNUAL FEE DUE: $281.00(Due on or before your anniversary date) <br /> COUNTY: Jackson <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 your revised written annual report and annual report map 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: Richard F. Wyatt <br /> Permittee Name: Wyatt Redi-Mix Co <br /> Address: P.O. Box 1052 <br /> Walden, CO 80480 <br /> Phone Number: (970) 723-4471 <br /> Fax Number: (970) 723-3222 <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 /> Signature of Corporate Officer or Owner <br /> Date <br /> M SPERM nAMASTER DOCUMENTS11.I-AF-01 <br />