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~ <br />V ANNT1Ai, FFF, and RF.P(iRT RF.t7TiF.ST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />t/ Graud Junction Pipe & Supply Co. <br />~M-1979-089 <br />23 Road Pit <br />July 25, 2006 <br />RECE!!/Ep <br />~~~JUL 24 7.OQg <br />" Division of AAirterats artd Aealagr <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />According to~C.R:S. 34-32:5-1-16 or C.R:S. 34-32-I16,-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 <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 Tnnr revised written annnal rennrt and annual re nn rt maw to this form- The Annual Report <br />& Fee requirement is not met until we have received the following 3 components: ff"P- r~ nrt, and acsnciarPd <br />malt (A113 are required regardless of the level of disturbance or absence of disturbance during the previous <br />year). Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />since for a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Edward J. Settle <br />Permittee Name: Grand Juncfion Pipe & Supply Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4604 <br />Fax Number: (970) 243-6703 <br />If you have additional comments andlor 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 />I~~ <br />Signature of rporate Officer, Owner, or Designee <br />tz-OG <br />Date <br />