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<br />pl Y ~""' <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Grand Junction Concrete Pipe Co. <br />M-1981-243 <br />S Fruita Grav Pit <br />February 16, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />RE~EIVE~ <br />FEB ~ ~ ?006 <br />Drvrsron of Minerals antl 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-a€fected-]and, <br />reclamation accomplished to date and during the 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 ynnr revised written anneal re_nnrt and anneal report m ~n to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sufftce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Edward J. Settle <br />Permittee Name: Grand Junction Concrete Pipe Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4604 <br />Fax Number: (970) 243-6703 <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 />~~~- <br />Signature of C rporate Officer, Owner, or Designee <br />'Z- LO - O(n <br />Date <br />