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~, = : _ s~.~~©~ III IIIIIIIII <br />- •~ <br />ANNUAL REPORT <br />PERMTTTEE NAME: T M Russell & R C Barger ~~~~~~/~® <br />PERMIT NO.: M-1980-037-HR $E~ 2 6 2~~ <br />OPERATION NAME: Ingleside Quarry Division of Aginerals and Geology <br />ANNIVERSARY DATE: October 1, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $688.00 <br />COUNTY: Larimer <br />- ~- Accordingrta'C:R:S: 3~2-1 iG~3)(aj~ eaciryea~on~the anniversarydate ofthe permit,-an operator"shall - <br />submit the annual 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 that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report mau and written resort to this annual report. Please <br />note that an adequately labeled map that clearly delineates and includes the above elements may <br />suffice for a Written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: ~~' a.e~/~ Company: Pro.,~~c~' s~.o lova~,/~~ <br />Address: I? O . t3~x' .~6.rv Phone No.: (7/~ ) .579 A/o cL <br />l'D/o , SN/ S l0 8a 9'3 3 FAX No.: (7/ ?) .Sf9-.f3i.~ <br />- - - - - " e-mail: - <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a sepazate sheet and attach it to this report form along with your map and/or written <br />report. <br />^ ~ ~~~~~ <br />Signatu • of Q' rporate O ce , or Owner Date <br />INSTRUCTIONS ON BACK <br />M:IPERMII4MASTERD000MENTSIM-AF-01 <br />