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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />ANNUAL FEE and REPORT REQUEST <br />United Companies of Mesa County, Inc. <br />M-2001-077 <br />Piceance Pit <br />August 28, 2002 <br />RECErvEo <br />AUG 2 6 2002 <br />Division of Minerals and 6eofagy <br />$281.00 (Due on or before your anniversary date) <br />Rio Blanco <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 your revised written annual resort 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Perrnittee Contact: -Peter~tegtnnmi-' <br />Permittee Name: p mes <br />Address: 2273 River Rd. <br />D(dCaS~iz ~(.~'".,a4f.>i YNC.. r~.bG. u~A~P-LCpµy,~~Pf <br />V <br />Grand Junction, CO 81505 <br />Phone Number: (970) 243-4900 <br />Fax Number. -(970) 243-5945 <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 />Signature of Corporate fficer or Owner <br />/-LuSUS~ 22 , ZUoZ <br />Date <br />M iPERMITMASTERDOCUMENTSNI-AF-01 <br />