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23; SEF-2005 13:35 FROkFColorada Division of llinarals i Gealoay +13036328106 <br />~, ,:r, <br />PERMl1TEE NAME: <br />PERMIT NO,: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />C/anyon Sand & Gravel~T <br />~I-1988~A57 <br />////// Canyon Sand & Cravel <br />August Xb, 2005 <br />T-803 P.002/002 F-301 <br />r~~ <br />RECEIVED <br />V JEP 2 82005 <br />Division of Minerals ar,a ...~wyY <br />9iZ8I.00 (Doe on or before your anniversary date) <br />According ro CRS• 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall, sulmrit the armual fee; a report and map showing the extent of current disturbances to afYeeted land, <br />reclamation accomplished to date and during the paeceding year, ~ disttsbances that are anticipated to Occur <br />during the upcoming year, reclamation that still be performed during the comvtg year, the dates for the beginning <br />of active opetatons, and the date active operations ceased for the year, if arty. <br />please attach vonr vwised written atmoal txTnari g~ anaaal rernl j mn~ to shin Enrw._ Please note that rrry <br />adequately labe%d map that clearly delineates and inclrrdes the above etemears may sujjice for a written repan. <br />Division records indicare the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permitree Contact: Robert S. Scott <br />Permittee Name: Canycn Sand & Gravel <br />Address: P.o. Box a362 <br />Pagosa springs, co sl ls7 <br />/~ < <br />/I / f ~ !d' C~I~s7G//10 ~~ // <br />~izt ~ ~ /,n~n~yf-~ /~ 2XCa(/Zri7or~ <br />an~C rvr~a~ ,~~~o~~ ~~ <br />n~r~-G~ ah~s~v~l, vEufr ~ <br />~~ ~ SC- ~~~~ ~~~ obi <br />-eQ(S~ 4rcd CUG.Sf"S~~CS - ~~e- f°'~+FfS <br />Fhone Nutnber. (970) 731-0707 ~ ~erfcd '~vov~ ~ ~ l4 ~e is .t oaJ <br />Fax Number: (970)731-4707 ,es~al~s~~ T~s~~~s an `ic orfv ~cc(a~:., <br />. _ If you have additional om and/or informative that should be provided tc the Division, please provide it <br />bciow or attach it ro this form along with your written report and map. Amtual Report instructions are enclostd. <br />~~7~~~< <br />Signature of Corporate Officer, Owner, m Designee <br />Dare ~~~ .s <br />