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~,~ ~~ <br />ANNiIAi. FF.F, end RFP()RT RF,iIiTFCT ~cA~~~` ~~ ~~ <br />®ibistnn ca ' 3 <br />PERMITTEE NAME: Mountain Region Corporation ntM'9p~ats <br />PERMTI' NO.: M-1995-005 antlCeU~°"' <br />OPERATION NAME: Orchard Mesa Aggr <br />ANNNERSARY DATE: February 16, 2004 <br />ANNUAL FEE DUE: $688.00 (Due on or beSore your anniversary date) <br />COUNTY: Mesa <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 />shat sl n~mit the annua -fee-a report and malrshowing--the -extent-of current -disturbances-tc- sffected -land,-- <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 the year, if any. <br />Please attach y~ir reviced written annnal repprt end annual re~prt m ~n 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 />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Sandra R. DuCray <br />Permittee Name: Mountain Region Corporation <br />Address: 117 - 29 3/4 Rd. <br />Grand Junction, CO 81503 <br />~jyt7 <br />Phone Number: (383) 242-5461 <br />Fax Number: (970) 242-6728 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed, <br />SignCrate ~cer~ er, or Designee <br />~„ L,9~Q~ <br />Date <br />M:~PERMIT4MASTERDOCUMENTS~M-AF-01 <br />