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<br />PERMITTEE NAME: Charles W Houchin <br />PERMIT NO.: M-1980-249 <br />OPERATION NAME: Houchin Gravel Pit <br />ANNIVERSARY DATE: February 4, 2005 <br />~ti~tC;iif2%~~ <br />JAN 2 5 2C~5 <br />..., . ,~m+la8y <br />_.::ac.. ..t ~...... . <br />ANNUAL FEE DUE: $281,00 (Due on or before your anniversary date) Y~ <br />COUNTY: El Paso <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 />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 y~~r reviced written annual report and annnal re~prt maw to this form. Please note thal an <br />adequately labeled map that cdearly 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: Charles Houchin <br />Permittee Name: Charles W Houchin <br />Address: ~ P.O. Box 162 <br />Green Mountain Falls, CO 80819 <br />Phone Number: (719) 684-9285 <br />Fax Number: (715) 684-2695 <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 enclosed. <br />Signature of Corp rate tcer, Owner, or Designee <br />ZY~~aS-' <br />Dat <br />