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,;_ .. <br />.~ <br />,, <br /> <br />ANNUAL REPORT <br />PERMTI'TEE NAME: Glacier Gravel Products <br />PERMIT NO.: M-1985-001 <br />iii~iininiimiui <br />~~~I~~. <br />OPERATION NAME: J & J Pit R~C~~~~Ir~~ .i <br />ANNIVERSARY DATE: June 27, 2000 ~, N a~~Q"~~'Q <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 .~u'~ <br />COUNTY: La Plata Div~~pf[p~Mt wiaesaa(ie0109~ <br />According to C.R.S. 34-32-1 l6(3)(a), each year, on the anniversary date of [he permi , an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances t affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the co~ing yeaz, the <br />dates for the beginning of active operations, and the date active operations ceased fo the year, if any. <br />rt. Please <br />note that an adequately labeled nx that clearly tlelineures ant! incG~des the above a ernents may <br />sn~ce for a written report. ~~ ~,J` I fJt N~, ~C~j~JI l ~ ~~ <br />Please type or print the current contact p son's name, mailing address, and phone number in the space <br />provided: <br />Contact Name:p I 1 Company <br />Address: ~ G~ ~"1 k.) Phone No.: <br />~ l`~ 'S ~ f n FAX No.: ( 1 ~ <br />If there are additional comments and/or information that should be provided to the ivision, please <br />provide it on a separate sheet and attach it to this report form along with your map a~r d/or written <br />report. <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />hf WERMlIVd ASTGRDOCUMENTSNI-AF~01 <br />