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- _ _ .-. <br />III ~II~II~II~~II III <br />999 <br />ANNUAL REPORT <br />r <br />~~`t ~~ <br />o T <br />PERMITTEE NAME: David Goss "pFpO~~ <br />PERMIT NO.: M-85-140 RECEIVED <br />OPERATION NAME: Goss Sand & Gravel ppR 21 1999 <br />ANNIVERSARY DATE: January 24, 1999 •;vis7onofMinerals&GeolOgy <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: EI Paso <br />According to C.R.S-3a=32=1~1b(3j(a), each year, on the anniversary dale of the permit, an operator <br />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 <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginnAin of active operations,~/a~n~d the date active operations ceased for the <br />year, if any. ~ ~ U~Z4 ~_~J~' `'Q~ ~.~ss~~'~ ~~/~Y~ <br />Please attac~ ydur revised annual reuo'"i`t maa and ~r~tte~n'r p rt to`~tl-is annual ~g <br />report. Please note that an adeq««tely lnbeled mnp d7«t cleurly delineates and includes d:e «bo\;g /f <br />elements m«y snff/ce for « written report. l ~!~, <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: ~ a ss S`~~v~~ vompany: D ~~ (` ~ ~""~~ <br />A//d~~dress~07~~ /~L, CO~ ""7 Phone No.: ~(9) G~3^ <br />L~~~(7ti~ l A ~o ~ ~ ~ Fax No.: (~.__..__._ <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signatur of Corp to Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />A7 bss\pmm4nrrgr\lormsVirpnn Rrgmn:d Isuer.tlx <br />