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NOV 1 5 2002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Ouray County <br />M-1991-097 <br />Triple R Gravel Pit <br />November 26, 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Montrose <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 <br />__. _ <operato~shall-submit-the-annual-fee,-a-report-and-map-showi b-the-extent-of-current-disturbances-to-sffected- - <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please a_tt_ach your revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates mtd includes the above elements may suffice for a written <br />report. <br />Division records indicate the following pemtittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bob Wolford <br />Permittee Name: Ouray County <br />Address: <br />Phone Number: <br />Fax Number: <br />P.O. Box 456 <br />Ridgeway, CO 81432 <br />(970)626-5391 <br />(970)626-4439 <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach it to [his form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corporate fficer, Owner, or Designee <br />t/- ,7 - o ~. <br />Dale <br />M:~PERMRwIASTERDDCUMENTSU~I-AF-04 <br />