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ANNUAL FEE and REPORT REQUEST <br />~ '~-" <br />RECEIVE® <br />MAR 1 8 2002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPJERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />J and M Schmahl <br />M-1984-001 <br />Surface Rock Pit <br />April 4, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />Division of Minerals and Geology <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 current disturbances to affected land, <br />reciamalion'accoitiplislted to date and during ehe 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 vour revised written annual reuort and annual reuort 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: John Schmahl <br />Permittee Name: J and M Schmahl <br />Address: 2301 River Rd. <br />Grand Junction, CO 81505 <br />Phone Number: (970) 242-8046 <br />/0 .' ~P d N~~~ m ; J` 1't/AS <br />~~~ <br />Fax_Nurnber;_ _(970 242=5018 __ _ ___, _ _ _ _ _ <br />If you have additional comments and/or information that should be provided to [he Division, please provide i[ <br />below or attach it to this form along with your written report and map. Annual Repor[ instructions are enclosed. <br />Signature of Corporate Officer or Owner <br />Date <br />M:~PERMnN1AS7ERD000MENTSU1-AF-01 <br />