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' : • ~~I II~II~II~II~~ ~I~ <br />ANNUAL REPORT <br />PERMITTEE NAME: Washington County <br />~:r~ rasa- 3 <br />OPERATION NAME: Nickell Gravel Pit <br />ANNNERSARY DATE: August 25, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Washington <br />• ~,~~ <br />,f~~'~~ r <br />\` <br />~E~E~vED <br />pUG 25 1999 <br />,:: •~ctM`~ta~&~~w4Y <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and [he date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note that an ade9uately labeled nutp that clearly delineates and <br />includes the above elements may suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: ~~ µ ~~~.,,~ <br />Addre~~tss: ~(p2n ~~ C_'C <br />$U~UI <br />Company: ~~1~=~c R . • ~ 3 <br />Phone No.: (970) 383-„?,2l(„ <br />Fax No.: (970 ) 383 - J~ t 3 <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report fors[[ along with your map and/or <br />written report. <br />~gnatu e of Corporate Offic r, or Owner Date <br />INSTRUCTIONS ON BACK <br />