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<br />PER'VIITTEE NAME: <br />PERtiIIT NO.: <br />OPERATION V ANE: <br />:~\~IIVERSARY DATE <br />.5~`NCJAL FEE DUE: <br />COTS-NTY: <br />A~T~iTiAT, FFF. and RFP(1RT RF(ITTFST <br />Kirkland Construction, RLLP ' <br />b1-1998-038 <br />Trvo Rivers <br />August 3, 2003 <br />S688.00 (Due on or before your anniversary date) <br />Pueblo <br />RECEIVED <br />AUG 0 6 2003 <br />Dirision ~f Mineral's and Geology <br />Accordinv to C.R.S. 3^-32.5-116 or C.R.S. 34=;2-11'6, each year, on the anniversary date of the permit, an operator <br />=;:a11 subn~t the anacai fe°. a report and map shotivina the extent of current disturbances to affected land. <br />reclamatica accomplisl.-izd to date and during the preceding year, new disturbances that are anticipated tc occur <br />daring the upcoming year, reclamation that will ba perormed during the corning year, the dates for the beginning <br />o active upzradons; and the date active operations czased for the year; if aay. <br />Pla~c~at*_a ~~~m+r recited :i ri tten anm+al *er~rt and anmral re~nrt man to Chic fnryt., Please note that nn <br />ndequarely labeled map that clearly delineates and includes the nbove elements may st ffrce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joe C. Baxter <br />Pertnittee Name: Kirkland Constmction, RLLP <br />Address: 2101 bfain St=f" <br />P.O. Box 580 <br />Rve. CO 81069 <br />Phone Number: (719) d5S-3.85 <br />Fax Number: (719) 489-2265 <br />If you have additional coc~menr aralor information that should be provided to the Division, please provide it <br />below or attach it to this form along with your a;itten report and map. annual Repot instructions are encloszd. <br />St azure of Corporatz Officer, Owner, or Designee <br />~~ ` <br />~- a s~- X003 <br />Date <br />MIPERMIM7ASTERD000MEMS~M-AF-01 <br /> <br />