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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />High Flume Gravel Pit, Inc. <br />M-1990-093 <br />High Flume Gravel Pit <br />October 24, 2005 <br />$688.00 (Due on or before your anniversary date) <br />La Plata <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 cun•ent 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 yeaz, 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 ynnr revised written anneal report and annual re nn rt m,~ to this form. Please note [hat an <br />adequately labeled map that clearly delineates and includes the above elements may sufftce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Marcia L. Talvitie <br />Permittee Name: High Flume Gravel Pit, Inc. <br />Address: P O Rox 2707 _ <br />Durango, CO 8130, <br />Phone Number: (970) 247-2172 <br />Fax Number: (970) 259-3631 <br />OK <br />~% Gour Comers Mg~iA/S <br />RO. goX ,Z 707 <br />8/302 ~7D 7 <br />OK <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 />~~LCta.~O/1.t.~tG~ii {nr rL~PI~I.SIfJCMUM~ <br />Signature of Corporate Officer, Owner, or Designee <br />~ OL'ttoker-~DOS <br />Date <br />