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~.b M <br />~~y~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNTJAT, FF.F, and REPORT RF.OiiF.ST <br />Popejoy Construction Company, Inc. <br />l/M-1986-124 <br />Cecil II Gravel Pit <br />October 24, 2005 <br />RECEIVEp <br />~CT 1 4 p005 <br />" alYlsion of Minerals a,~ u.~logy <br />$281.00 (Due on or before your anniversary date) <br />Washington <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 />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 Che year, if any. <br />Please attach your revised written anneal re~=nnrt and anneal report msn to this form- Please note [hat an <br />adequately labeled map that clearly delineates and includes the above elemeuts may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Perntittee Contact: Donald G. Popejoy <br />Permittee Name: Popejoy Construction Company, Inc. <br />Address: P.O. Box 385 <br />Ulysses, KS 67880 <br />Phone Number: {346}356-3494- D~0 - 3 S(o - ,3 `f r*J `~ <br />Fax Number: ~ f ~l-6}~3~6.4-7~- !v aD - 3 5 !a - ~ '7 ~ ~ <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 />07 ~~ <br />Signature of C o e rcer, Owner, or Designee <br />~GTlO, Z/~O ~` <br />Date <br />