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<br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Parkerson Construction Co. <br />M-1978-323 <br />Woodring Pit <br />November 22, 2002 <br />NOV 0 62002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />According to C.R.S. 34-32.5-I ]6 or C.R.S. 34-32-1 ]6, 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 carrent'distutbances to affected land;_ <br />- reclamation accomplished to date and during [he preceding year, new disturbances that~are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, [he dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual reuort 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 pemtittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Alan Parkerson <br />Permittee Name: Parkerson Constmction Co. <br />Address: 710 S. 15th St. <br />Phone Number: <br />Fax Number: <br />Grand Junction, CO 81501 <br />(970)242-8134 <br />(970)242-8977 <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 />Sign ture of Cor orate Officer, Owner, or Designee <br />-O <br />Date <br />M iPERM I7IMASTERD000MENTSN7-AF-OI <br />