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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Cross Mountain Ranch Ltd. Partnership <br />M-1979-102 <br />Kagie Gravel Pit <br />June 21, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Routt <br />REDEIVED <br />JUN ? 4 2Q02 <br />Division of Minetals and Geology <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 />-' shall submit'the-annual fee-a-report-and map-showing-the-extent-of-current-disturbances_to affected. Land, __ <br />reclamation accomplished to date and during the preceding year, new disturbances that aze anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the beginning <br />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 incltules the above elements may suffice for a written report. <br />Division records indicate [he following permi[tee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Aleah Hockin <br />Permittee Name: Cross Mountain Ranch Ltd. Partnership <br />Address; P,O. Box 1029 <br />Hayden, CO 81639 <br />Phoue Number: (970) 276-3718 <br />Fax Number. (970) 276-3718 <br />If you have additional comments and/or information [hat 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 />I <br />Signature of Corporate Officer o ner <br />~-a/-n ~ <br />Date <br />A1e~{1 1Joedrr~, - KPM.ty <br />CC ~:AN.Tf~N~ITNG. <br />M:NERMIT\MASTERD000MEMSN~I-AF-01 <br />