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o~' ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />River Bottom Land Corporation <br />M-1992-100 <br />River Bottom Land Gravel <br />February 5, 2004 <br /> <br />RECEIVED <br />`~ 26 2004 <br />Division of Minerals & GeoloBY <br />$281.00 (Due on or before your anniversary date) <br />Delta <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 />s aTi 'il'~ttn't-ttte~mual-€ee; a-reperi-and ent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipate 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 ymlr revised written anneal re~nrf and anneal rennrt 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: Patricia Farnsworth <br />Permittee Name: <br />River Bottom Land Corporation <br />Address: <br />Phone Number: <br />Fax Number: <br />Paonia, CO 81428 <br />C>,vvt.l2 <br />~'~--Q-J <br />I'lS u~ ~ ~ :3 3 <br />~t~~~ <br />(970) 527-4434 ~r*~-//`-~2 <br />(970) 527-5522 ~~C}-rr~ Q - <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 />ignature of Corp r9t icer, Owner, or Designee <br />~ ~a~~ 1 v~ <br />Date <br />M:~PERMITMASTERDOCUMENTSU9-AF-01 <br />~~,d~ <br />ss'S <br />e~"~ <br />