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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~ <br />RECEIVED <br />AUG 0 52002 <br />Division of Minerals and Deology . <br />Otero County (Engineering) <br />M-1978-267 <br />Argo Gravel Pit <br />August 26, 2002 <br />$658.00 (Due on or before your anniversary date) <br />Otero <br />According to C.R.S. 34-32.5-116 or C.R.S. 3432-116, each year, on the anniversary date of the permit, an <br />__ -operator shall submit_the.annual fee, a report and map showing the-extent of.current-disturbances to-affected_ <br />Land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and [he 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 <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Kenneth S. Pazker <br />Permittee Name: Otero County (Engineering) <br />Address: P.O. Box 511 <br />La Junta, CO 81050 <br />Phone Number: (719) 383-3035 <br />Fax Number: (719) 383-3935 <br />If you have additional comments and/or information that should be provided to [he Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corporate Officer or Owner <br />- a~-oa-- <br />Date <br />M9PERMINAASTERD000MENTSN4-AF-d7 <br />