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~ytii <br />RECEIVED <br />DEC 1 42005 <br />Division of Minerals and Geology <br />PERMI'I"I'EE NAME: Morgan Sand and Gravel <br />PERMIT NO.: M-1977-094 <br />OPERATION NAME: Westhoff Pit <br />ANNIVERSARY DATE: December 20, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Morgan <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 operator <br />- --- s~IT sub`m"'ti t-tie annual lee, a repoit'and map sfiow~ng a ex en of current disturbances to'afI'ectea Ian3; ~"- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anneal report and anneal rennet main to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since jor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gary Westhoff <br />Permittee Name: Morgan Sand and Gravel <br />Address: P.O. Box 1443 <br />Ft Morgan, CO 80701 <br />Phone Number: (970) 867-8074 <br />Fax Number: (970) 867-8074 <br />T~ S(~7 - 377 S~- <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 enclosed. <br />Signatt a of rporate Officer, O Designee <br />/a-~z-~~ <br />Date <br />