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<br />ANNUAL FEE and REPORT REQUEST <br />RECE~1/ED <br />APR 1 2 2~l? <br />Division of iNirtt}ra#, r ff66foQy <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Sunnyside Gravel <br />M-1986-033 <br />Hess Pit <br />March 11, 2002 <br />$281.00 (Due on or before your anniversary date) <br />La Plata <br />According [o 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 />shall submit the annual Fee, a report and map showing the extent of current disturbances to affected land, <br />^_~reclamation accomplished_t4_date.and ~lurine 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 Vour revised written annual report and annual reuort map 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 permit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Alton Hess <br />Perrrlittee Name: Sunnyside Gravel <br />Address: 9983 Hwy. 550 <br />Durango, CO 81301 <br />Phone Number: (970) 247-1596 <br />Fax Number: _ (970) 247-1650 - !,M_ _ -_ __ <br />_ ___.. <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ to this form along with your written report and map. Annua] Report instmctions are enclosed. <br />nature of orporate Officer or Owner <br />~- 9-ate -. - <br />Date - - <br />M:W ERMITN4ASTERD000MENTSN~7-AF-OI <br />