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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />James D. and Beckie J. Krakel <br />M-1994-096 <br />Russell Gravel Pit <br />April 14, 2002 <br />$281.00 (Due on or before your anuiversary date) <br />Larimer <br />RECE[ ~E~ <br />APR 15 4~~? <br />Division of Minerals and Geofog; <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 />teclaruatiun accumplisLed w date ant during tire yroecding ycar, .~ecr-disturbances-that are an[itipat.^,d t:r cccur <br />during [he upcoming year, reclamation that will be performed during the coming year, [he dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual reuort and annual resort map 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: 6ladps-RttSSeH-• <br />Permittee Name: James D. and Beckie J. Krakel <br />Address: .}~36-P~~- <br />Wellington,.CO 80549 <br />~~ -~ ~ G vh ~'ecT <br /> <br />Phone Number: (!1.36j-Sfr8=9G1'@- _ S -7 D ' S L B ~ 7 ~(D ~ <br />Fax Number (6~78}s68~krt6--' _ $et wt '>' <br />if you have additional comments and/or information that should be provided to [he 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 />of Comorate Officer or Owner <br />~-~7-~~ <br />D~~. <br />M:~PERMR VNASTERDOCl1MENTSVN-AF-01 <br />