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III IIIIIII II IIII III ANNUAL REPORT <br /> 999 <br /> K !�( o . <br /> PERMTI'TEE NAME: Dewitt Excavating, C. wCEIVED C <br /> PERMIT NO.: M-83-132 ^~ <br /> OPERATION NAME: Dewitt Excavating �>� Q� ° JUL 23 1999 <br /> ANNIVERSARY DATE: July 29, 1999 tMinerabBGeolo9Y <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br /> COUNTY: Prowers PAID vvv <br /> According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br /> operator shall submit the annual fee, a t�orrand map showing the extent of current disturbances <br /> to affected land, reclamation accomplished to date and during the preceding year, new <br /> disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br /> performed during the coming year, the dates for the beginning of active operations, and the date <br /> active operations ceased for the year, if any. <br /> Please attach your revised annual report map and written report to this <br /> annual report. Please note that an adequately labeled map that clearly delineates and <br /> includes the above elements may since far a written report. <br /> Please type or print the current contact person's name, mailing address, and phone number in the <br /> space provided: <br /> Contact Name: Company:D1E&)t G'J Ex, , <br /> 5 ) �— T�rl <br /> Address: J Phone No.. ( / �� Y�-s <br /> oT�! `2 • G, Ly ' Fax No.: (7I ) 33 6_ VISn <br /> 5�/ LS �t� <br /> If there are additional comments and/or information that should be provided to the Division, <br /> please provide it on a separate sheet and attach it to this report form along with your map and/or <br /> written report. <br /> wzy <br /> Sig ature of Corporate Officer, or Owner Date <br /> INSTRUCTIONS ON BACK <br />