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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 />Lucio Vasquez <br />M-1994121 <br />Vasquez Quarry No 2 <br />April 13, 2002 <br />$281.00 (Due on or before your anniversary date) <br />$oulder <br />RECEIVED <br />APR 1 0 2002 <br />Division of Minerals and Geology <br />_ According to C.R.S. 3432.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operntor <br />shall-suhmt[ ttie annuat'fee-a'reporrattd-map-showing the- exrenE of=.current-disturbances to affected land, _ <br />reclamation accomplished to date and during the preceding yeaz, 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 yeaz, if any. <br />Please attach your revised written annual report and annual report maD to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Divisioti records iridicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Con[act: Lucio Vasquez <br />Pertnittee Name: Lucio Vasquez <br />Address: P.O. Box 938 Zf 2~~~~~' //~ .5.±r <br />.zi~- <br />Lyons, CO 80540 ~~l/f ~. !~_ <br />Phone Number: (970) 215-7547 _~/2~' ~~ rSf [OS~ <br />Fax Number: _~~-~~~~ <br />R 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 trap. Annual Report instructions are enclosed. <br />Signature of Co of to Officer Owner <br />Date <br />M:WERMi'M1ASfERD000MEM'S1M-AF-0t <br />