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<br />PERMITTEE NAME: Corkle Construction ~ECE=VED <br />PERMITNO.: M-]995-023 MAY 1 4 2003 <br />OPERATION NAME: Peterson Pit <br />ANNIVERSARY DATE: June 8, 2003 Division at Minerals and Geolo~Y <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Jackson <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, each year, on the anniversary date of the permit, an operator <br />shall "submit the,'annual fee`, `a repott`arid -map showing the exteni'of curreht-dis[urba_nces to_-affected_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 />Ptease attach ynnr revised written annual report and anneal rennrt mad to this form. Please note that an <br />adequately labeled map that clear/y 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: Harry E. Corkle <br />Permittee Name: Corkle Construction <br />Address: Box 306 <br /> Walden, CO 80480 <br />Phone Number: (970) 723-4676 <br />Fax Number: (970) 723-3208 <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 />E- ~ <br />Signature orporate fficer, Owner, or Designee <br />S- <br />Date <br />M:\PERM INAASTERDOC UM ENTSVN-AF-01 <br />