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L <br />• III IIIIIIIII IIII III <br />V <br />ANNUAL FEE and REPORT REOUESTR ECE I V ED <br /> <br /> JAN 0 3 2002 <br />PERMITTEE NAME: Lorimer County <br />PERMIT' NO.: M-1985-135 Division of Minerals end Geology <br />OPERATION NAME: Horton Gravel Pit <br />ANNIVERSARY DATE: January 31, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Lorimer <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 to affected <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 attach vour revised written annual resort and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Dennis C. Morrison <br />Permittee Name: <br />Address: <br />Larimer County <br />P.O. Box 1190 <br />Fort Collins, CO 80522 <br />Phone Number: (970) 498-652 <br />Fax Number: (970) 221-0232 <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 <br />enclosed. <br />Si a[ure of C~ rate O cer or Owner <br />\~. ~~ ~~ <br />Date <br />M'WERMffN1ASTERD000MENfSN1~AF-01 <br />