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`K # �s�° ' 1111111111111111111 <br /> • 999 <br /> ANNUAL FEE and REPORT REOUEST RE13EIVEp <br /> PERMITTEE NAME: Hardrock Sand and Gravel NOV 14 2000 <br /> PERMIT NO.: M-1977-443 Division of 1linerals and Geology <br /> OPERATION NAME: Moon Pit Nr <br /> ANNIVERSARY DATE: November 8, 2000 <br /> ANNUAL FEE DUE: $281.00(Due on or before your anniversary date) <br /> COUNTY: Moffat <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 <br /> operator shall submit the annual fee, a report and map showing-the extent of current disturbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances that ire anticipated to <br /> occur 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 /> Please attach your revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may since for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Pat Weber <br /> Permittee Name: Hardrock Sand and Gravel <br /> Address: P.O. Box 141 <br /> Craig, CO 81626 <br /> Phone Number: (970) 824-3944 <br /> Fax Number: <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 <br /> enclosed. 41a <br /> eX2+/1' 12WPpdi2y fLJJ�/li�'Eils / r <br /> Si azure of Corporate Officer or Owner <br /> Date <br /> AIAPERMR MASTERDOCUAIENTSW-AF 01 <br />