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999 <br /> • v ANNUAL FEE and REPORT REOUEST REC <br /> EI VED <br /> PERMITTEE NAME: Otero County (Engineering) FEB 0 5 1001 <br /> PERMIT NO.: M-1981-279 Division of Minerals and Geology <br /> OPERATION NAME: Hancock Gravel Pit <br /> ANNIVERSARY DATE: February 1,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Otero <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 /> 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 your revised written annual report and annual report 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 <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Kenneth S. Parker <br /> Permittee Name: Otero County(Engineering) <br /> Address: P.O. Box 511 <br /> La Junta, CO 81050 <br /> I <br /> Phone Number: (719) 383-3035 <br /> Fax Number: (719) 383-3935 <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 /> Signatur of Corporate Offic r Owner <br /> 0� <br /> Date <br /> N1 TERMITMASTERDOCUMENTSW-AF-04/ <br />