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,/ <br />..~ <br />PERMITTEE NAME: rande County <br />PERMIT NO.: 8-071 <br />OPERATION NAME: Del Norte Gravel Pit <br />ANNIVERSARY DATE: November 25, 2005 <br />rco <br />r.(Nl.•iin ~ . <br />~~ <br />r!'~lf ~~ =. Z~OJ <br /> <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: ltio Grande <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 />--operator-shall-submit the-annual-fee,-a-report-and-map-showing-the-extent-of-current disturbances-to-affected - - -- <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <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 />Fleece attach ym~r revised written anm~al renort and annual rennrt map fn 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: <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Lawrence "Buddy" Shaver <br />Rio Grande County <br />168 N. Washington <br />Monte Vista, CO 81144 <br />(719)852-4781 <br />(719)852-0305 <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 />Signature of Corporate Officer, Owner, or Designee <br />Date ~ <br />/fFsRP% <br />ANNTiAi <br />/' 12io <br />-197 <br />M:~PERMITMASTERDOCUMENTSVvl-AF-04 <br />