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<br />~~% <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Louis M. Wyman !/ <br />.~1~I-1983-037 <br />Wyman Pit <br />May 31, 2005 <br />~~.~ ~ 0 '~;,,,0 <br />Qislyinerars an9 Geology <br />$281.00 (Due on or before your anniversary date) <br />Routt <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 />shall submit the annual fee, a report and map showing the extent of current disturbances to affected 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 ymrr revised written annnal re~7nrt and annual re~pnrt mar to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: L. M. Wyman <br />Permittee Name: Louis M. Wyman <br />Address: P.O. Box 278 <br />Phone Number: <br />Fax Number: <br />Craig, CO 81626 <br />(303)824-6431 <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 />cE~~~° <br />~1 . L~ RE 1pp6 <br />Signature of Corporate Officer, Owner, o esignee 'PN ~ <br />r ~,. <br />p bf.~ <br />1-~JJ -o tD <br />Date aC9gC~O <br />1~:.. <br />