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:~ <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Rio Blauco County <br />M-1978-002 <br />Texas Creek Pit <br />February 23, 2003 <br />$281.00 (Due on or before your anniversary date) <br />Rio Blanco <br />RECEIVED <br />FEB i & 2003 <br />Division 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 permit, an <br />~opecator~hall_submit the annual fee~a report and -map showirig the extent of current disturbances to affeeted'~ - <br />land, reclamation accomplished to date and during the preceding year,-nevcTdisturbanees-that-arc-anticipated_tn _ <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attarh ynnr revised written annnal resort and annnal rennrt mare to this form- please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Ron Leeper <br />Permittee Name: Rio Blanco County <br />Address: 570 2nd St. <br />Meeker, CO 81641 <br />Phone Number: (970) 878-5601 <br />Fax Number: (970) 878-3396 <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 <br />enclosed. <br />~~ <br />Signature of Corporate Officer, Owner, or Designee <br />~-~9-03 <br />Dale <br />M:~PERMITV.1ASTERD000MENTS~M-AF-04 <br />