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<br />PERMITTEE NAME: Grand Junction Pipe & Supply Co. <br />PERMIT NO.: M-1997-053 13 E D E I V E D <br />OPERATION NAME: Clifton Water Gravel Pit QCT ~ Z ~(~ <br />ANNIVERSARY DATE: October 3, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversar~"~3~ep1 Minerele and Geology <br />COUNTY: Mesa <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 I <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 ymn• revised written annual report and annual re nn rt 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: Edward J. Settle <br />Permittee Name: Grand Junction Pipe & Supply Co. <br />Address: P.O. Box 1849 <br />Phone Number: <br />Fax Number: <br />Grand Junction, CO 81502 <br />(970)243-4604 <br />(970)241-6703 <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 />~ - <br />Signature of C orate Officer, Owner, or Designee <br />s~-o3 <br />Date <br />