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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Hardrock Sand and Gravel <br />M-1990-140 <br />Martin Pit 1-A <br />December 18, 2001 <br />RECEIVED <br />MAR 0 82002 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Moffat <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 />reclamation accomplislsed`to~i ate-arid during the preceding y`ear,-newasturbances iha[ are-antictpate to occu ~, <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 yeaz, if any. <br />Please attach vour revised written annual resort and annual report maa to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following pemuttee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Pat J. Weber <br />Permittee Name: Hazdrock Sand and Gravel <br />Address: P.O. Box 141 <br />Phone Number: <br />Fax Number: <br />Craig, CO 81626 <br />~~,,tt6s3 <br />(970) 824-351 <br />~a -~1 ~{ -~G,S3 <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 />S' azure o Corporate Officer or Owner _ _ _ _ _ <br />~-~-tea - <br />Date <br />M:~PERMRN4ASTERD000MENTSUI-AF-OI <br />