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G ~1 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Robert D and Lavelle Corey <br />M-1987-024 <br />Corey Gravel Pit #3 <br />April 17, 2004 <br />RECEI VECy <br />APR 2 11004 <br />~litloc of IMiae7atb oao uL~,.d" <br />$281.00 (Due on or before your anniversary date) <br />Montrose <br />__ According,to C.R.S. 34r32.5-116 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 ynnr revised written annual repprf and anneal rcnnrt 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: Judy DeVincentis ~ <br />Permittee Name: Robert D and Lavelle Corey -~ <br />Address: 3001 N. Townsend ~ <br /> Montrose, CO 81401 ~ <br />Phone Number: (970) 249-2431 /~ <br />Fax Number: (970) 249-0590 /~ <br />If you have additional comments and/or information that should be provided [o 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 />Date <br />