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<br />r <br />~ru\ 1 l (.~u~ <br />;"1~W.. [~~.. ... <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Beavers Construction Co./High Mesa Gravel L.L.C. <br />M-2000-067 <br />High Mesa Gravel Pit <br />March 15, 2005 <br />$688.00 (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 />_ _ _shall_submit ahe_ annual, fee,_a_report_and~map_showing the=extent of=cnrrent~isucbances to -affected land, ~ . <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 xpnr revised written anmial renort and annual reQnrt main 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: Art Beavers <br />Permittee Name: Beavers Construction Co./High Mesa Gravel L.L.C. <br />Address: 1A9k~4-I4+r~y-I39- <br />P.O. Box 638 <br />Phone Number: <br />Fax Number: <br />Paonia, CO 81428 <br />(970) 872-2323 <br />(970)872-2576 <br />35'~s ~wT~33 <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 />Signature of Corporate Officer, Owner, or Designee <br />Date <br />