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RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPdERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Elam Construction, Inc. <br />M-1980-085 <br />Vagneur Site <br />February 17, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Pitkin <br />FE8 i 4 Z003 <br />iliuision of Minerals and Geology <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 pemut, an <br />matt submit-the annual-tee; 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 y nor revised written anneal report and anneeal rennrt m}{R to thic 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Harold F. Elam <br />Permittee Name: Elam Construction, Inc. <br />Address: 1225 S. 7th St. <br />Grand Junction, CO 81501 <br />_ ..Phone Number: (970) 242-5370 _ ~ _ _ . _ _ _ <br />Fax Number: (970) 245-7716 <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 />~' .S ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />H cold F. Elam, President <br />.3 ~b aoo3 <br />Date <br />M 1PERMITMASTERD000MENTSVA-AF-01 <br />