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iii iiuiiiiiiiiiii <br />.~ ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Rio Grande County <br />M-1978-071 <br />Del Norte Gravel Pit <br />November 25, 2001 <br />$688.00 (Due on or before your anniversary date) <br />Rio Grande <br />RECEIVED <br />NOV 2 G 2001 <br />Division of Minerals and Geology <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, each year, on the anniversary date of [he permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual resort map to this form. Please note t/rat nrr <br />adequntely labeled mnp that clearly delhrentes mrd includes the above elements nary suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Petmit[ee Contact: Lawrence "Buddy" Shaver <br />Permittee Name: Rio Grande County <br />Address: 168 N. Washington <br /> ~111~ `~le ~LL Aa. Q, <br /> Monte Vista, CO 81144 P. h. ~'Al+l~, <br />Phone Number: (719) 852-4781 <br />Fax Number: (719) 852-0305 <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 <br />enclosed. <br />~~~ Y~S1~~~'t~~ <br />Signatur f Corporate Officer or Owner <br />/~ ~ d-d ~ <br />Date <br />A1.~PERM ITN1ASTERD000MHNTSUI~AF~Pf <br />