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~ tAi F~F a~EPORT REQUEST <br />PERMTfTEE NAMR; i-Beavers Construction Co./iHigh Mesa Gravel L.L.C. <br />PF,RMIT NO.: .iM-2000-067 ~~„ ?'?~ ;~': ' n 0" ,~ <br />OPERATION NAME: ]High Mesa Gravol Pit ~`~/?i7 0 5 7(I~l <br />ANNIVERSARY DATE: March 15, 2007 Division of ~~;,;amation, <br />ANNUAL PEE DLJk:: $$688.00 (Aac on or before your anniversary date) --~~1ining and Salaiy <br />COUNTY: Aclta <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 the permit, an operator <br />shall submit the-anraial-fee,-a-report- and-Wisp showing the-c~ctent of enrfettt disturbances-to affected land, <br />reclamation accomplished to date and daring the preceding year, sew 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 />Pleaso attach vonr reviused wrtten_annnal report and annual report map to this form. The Annaal Report <br />& Fee requirement is not met antil we have received the Following components: £e ree~norY. and associated <br />map. xf no new disturbances or reclamation have occurred darin¢ the nrevfous veer and no new changes to <br />the_orevlous year's man_a~e necescarV,_thon no new map is required. provided that the Operator shall state <br />this In the Annasl Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may su~icefor a written report. <br />Aivision records indicate the following permittee contact information. Please verify sad make any necessary <br />changes: <br />Pecmittee Contact: <br />P~.l a~K-li.sf~ <br />Permittee Name: Beavers-- Cenetractiatt ~13igh Mesa Gmvel L.L.C. <br />Address: <br />Phone Number: <br />Pax Number: <br />P---'-:z8 <br />QQr <br />0~~~~ <br /><{~70j'S92Z323 `7 ~ U~~ 01 - ~'~~~ <br />cs7a~s~.zsz6- ~~ o - a 6 3 - 7~i~ <br />If you have additional comments and/or information that should be provided to the Division, please providett <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature <br />