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ANNUAL FEE and REPORT REQUEST G® <br />PERMITTEE NAME: Elam Construction, Inc. `~V <br />~~G~ ti~~ <br />PERMIT NO.: M-1991-079 ~~(,~ oso~5 <br />~~ <br />OPERATION NAME: Mule Farm Gravel Pit o~~ <br />.i`S`oo <br />ANNIVERSARY DATE: February 18, 2002 O` <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br />According to C.R.S. 34-32.5-1 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annua_1 fee._a.report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances dlaCare anticipated to occw~ <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 vour 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Thomas A. Logue <br />Permittee Name: Elam Constmction, Inc. <br />Address: 1225 S. 7th St. <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-5370 <br />Fax Number:___ _ _ (9~ 245,7716 <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 <br />~4~/,0. AycTl <br />oz//~/oz __ _ <br />Date <br />M 1PERMfTU4ASTERDOC UMENTSVN-AF-01 <br />