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x <br />d <br /> ~E~EIVE® <br />PERMITTEE NAME: Delta County <br />PERMIT NO.: M-1978-304 OCT 2 7 2003 <br />OPERATION NAME: Triantos Gravel Pit <br /> Oiuision of Minerals and Geology <br />ANNIVERSARY DATE: November 13, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Delta <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 />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 />Please attach your revised written anmral report and annual re r~ t ma~to this form. Please note That an <br />adequately labeled map that clearly delineates and includes the above elements may since 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: Larry Record <br />Petmittee Name: Delta County <br />Address: 501 Palmer St., Ste. 227 <br />Delta, CO 81416 <br />---Phone Number:____ (970)_879_2100 -- <br />Fax Number: (970) 874-2114 <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 />~CGGC~'L /1 JJ /1-/LA ~~LY- ~C. <br />Sigtrature-of orporate Officer, Owner, or Designee <br />Date <br />2 O/O <br />M:\PERMI M1ASTERD000MENTSVN-AF-06 <br />