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r- <br />• <br />ANNUAL REPORT <br />PE~'.MfTTEE NAME: Baca County <br />PERMIT NO.: M-81-138 <br />OPERATION NAME: Gravel Pit No 17 <br />ANNNERSARY DATE: July 24, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Baca <br />iii iiuiuimiuii <br />~ 0°~ ~11~ <br />r~CEIVED <br />JUtd 0 4 1999 <br />:ninerale & Geology <br />According to C.-R.S. 34-32-116(31(al, each year, :on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual resort mau and written reuort to this <br />annual report. Plense note that an odegtuuely labeled nmp thnt clearly delinentes and <br />iududes tfte above elements may since for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: TED LASLEY <br />Address: 74t MATN CTRFFT <br />Company: BACA COUNTY DISTRICT II <br />Phone No.: ( 719 ) 523-6532 <br />Fax No.: ( 719 ) 523-6584 <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />s-a~-l9 <br />Signature of Corporate Offi r, or Owner Date <br />INSTRUCTIONS ON BACK <br />