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21-AUG-20D5 13:21 FROt~Calcrado Division of ilinerals & GealoQy +13038328106 <br />~~~~~ <br />ANNiTAi. PRF. an RF.Pf1RT RF iQ fTCT <br />PERMi17EE NAME: N/Colo Water Conservancy Dist <br />PERbII'I' NO.: vM-1981-085 <br />OPERATION NAME: Riprap Quarry Area <br />T-440 P.002/004 F-696 <br />~1 J <br />~s 2 s zoos <br />W'1 Oiv~aw . .i.ote84 <br />ANNJVERSARX DATE: duly 21, 2005 <br />ANNUM, FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Grand <br />According to C.R.S. 3432.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the pemrit, an <br />operator shall submit the annual fce, a report and reap showing the extent of current disturbances to af~'ected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that arc anticipated to <br />occss during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />PI a~h~mnr r 'c,-d wrttt n nm,al r Wort and aRnnL r'p~nrt ma to th~ia fnrm_ please note that an <br />uderluately labeled map rhar clearly delineates and includes the above elements may su~ce for a written <br />report. <br />Divisien records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jcny A, Westbrook <br />Permittee Name: N Colo Water Conservancy Dist <br />Address: P.O. Box 679 <br />Loveland, CO 80539 <br />Phone Number: (970) 667-2437 <br />Fax Number: (970) 663-6907 <br />Jim Struble <br />Northern Colorado Water Conservancy <br />District <br />220 Water Avenue <br />Berthoud, CO 80513 <br />970-532-7700 <br />970-532-0942 <br />1f you have additional comments and/or information that should be provided w the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />eRC10Sed. _ <br />Dale <br /> <br />M:~PERMITMASTlAppCVMCNTS~N-nF06 <br />