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.• :Yr• <br />ANNUAL FEE and REPORT REQUEST <br />JUl 2 52002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Grasser Construction, Inc. <br />M-2001-052 <br />McCormick Pit <br />August 2, 2002 <br /> <br />RECEIVED <br />4lvlalon of Minerals and OeologY <br />$688.00 (Due on or before your anniversary date) <br />Kit Carson <br />According to C.R.S. 34-32.5-I ] 6 or C.R.S. 34-32-] 16, 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 />- ieclamatio'n accomplished'to date a'nd during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming yeaz, the 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 report 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 />Permittee Contact: Daniel L. Grasser <br />Permittee Name: Grasser Construction, Inc. <br />Address: 18071 CR 31 <br />P.O. Box 192 <br />Stratton, CO 80836 <br />Phone Number (719) 348-5383 <br />---'~°--Fax-IVumb~r.----f7-19)345-543-1- --°-- --~--- --- -- ----- - - -- - <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 aze enclosed. <br />~~- ^ <br />Signature of Corpor to fficer or Owner <br />'9-- / ~~' .OZ <br />Date <br />M:IPERMITIMASTERDOCUMENTSN9-AF-OI <br />