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'; <br />. _ <br />~II ~I~~I~~II~~~~ ~I~ <br />999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Weld County <br />PERMIT NO.: M-1981-286 <br />OPERATION NAME: Thomas Gravel Pit 4 <br />ANNNERSARY DATE: March 1, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Weld <br />DECEIVED <br />f , O L~` ~C Ju <br />~rvis.on of Mineta~s ~ Geo1o9Y <br />~o~"yW7 <br />According to C.R.S. 34-32-116(3)(a), 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 <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />~~ <br />Please attach your revised annual report map and written report to this annual report. <br />Please note that nn nrlegemtely labeled map tkat clearly delineates and includes the above <br />elements may suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: ~(o,~~s.,n Company: W~~ A~Gf,~ 1n/or IL9 <br />Address: l~~ !'hk 75 g Phone No.: (97v )_35~-y~rxi r 3 75y <br />FAX No.: (97U) _3oy -G y97 <br />Gre e,i'~~ Cn pl~G~3 Z <br />If there are additional cotnments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />Ignature of orporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />I ITNA ASTER DOCII M ENTSN7-A F-Ol <br />