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~ III IIIIIIIIIIIII III <br />ANNUAL REPORT <br />PERMI-fTEE NAME: Conejos County <br />PERMIT NO.: N1-1987-097 <br />OPERATION NAME: La Florida Grav Pit <br />ANNN]?RSARY DATE: August 18, 2000 <br />ANNUP.L FEE DUE ON ANNNERSARY DATE: $281.00 <br />COUNTY: Conejos <br /> <br />J~~F~E~LFD <br />,) <br />Q/V/Sirn , ?QOo <br />.e,6ttnBta/S <br />&G <br />~~~~ ~ ~~ <br />According to C.R.S. 34-32-116(3)(aj, each yeaz, 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 yeaz, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming yeaz, the dates for [he beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please al.tach Your revised annual report map and written report to this annual report. <br />Please note that an adequately labeled map that clearly delineates m:d includes the nbove <br />elements may since for a 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: JdnI ~~-t-C v /27o Company: /t ~i6S ~R/~iA <br />Address:_~ 6 ~3 1..9Gc.rt:~ KagGC~1 (3 Phone No.: (7] ~) 3 ~~~ S 772 <br />QD ~aAr (S7 C.Dhe~to~C~(1 ~(l ~rf FAX No.: (fit 9 ) ~~'76' S~o6~ <br />e-mail: <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it to this report form along with your map and/or <br />written report. <br />Signature of Corporate Officer, or Owner <br />Date <br />INSTRUCTIONS ON BACK <br />AI:IPE RA I rR~1ASTER DOC UM EP7SR7-A F-6t <br />