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.. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Denver Water Department <br />M-1977-153 <br />Reclamation Pit No 1 <br />February 7,2004 <br />JAN 2 ~ ?Opy <br />division o) Minarals and GeotogY <br />$688.00 (Due on or before your anniversary date) <br />Adams <br /> <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 />shail~mit-the annual-fee, a reporC'and map'showing-the-extent of current-disturbances-to-a€feeted-land- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annnal re~nrt and annnal rennrt m ~n to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Director of Enginerring CF.PR.contact_last_name <br />Permittee Name: Denver Water Department <br />Address: 1600 W. 12th Ave. <br />Phone Number: <br />Fax Number: <br />3oa-vz.S-(a 8s 1 <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 enclosed. <br />Signa re of Corporate Officer, Owneree ~~ ~nr U`~+wl L~e.~G~ <br />23 , 2.00 3 <br />Date <br />Denver, CO 80204 <br />(303) 628-6000 <br />M:~PERMInMASTERD000MENTS4M-AF-01 <br />