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~, p~L <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Nienhueser Construction & Excavating Co <br />M-2001-018 <br />Schumacher II <br />April 19, 2004 <br />R~G~'d~ °~ <br />MAR~~~ <br />OiVision o/Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Logan <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 />' s}iall submit the annual-fee; areport -and-map showing`the~ezt"enTVf'current-distnrbarces-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 />Please attach your revised written annual rennrt and annual rennrt m ~n to Chic 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 petmittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Keith Nienhueser <br />Permittee Name: Nienhueser Construction & Excavating Co <br />Address: 1500 10th Ave. <br />P.O. Box 173 <br />Phone Number: <br />Fax Number: <br />Sidney, NE 69162 <br />(308) 254-3453 <br />(303) 254-3455 <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 aze enclosed. <br />Si ature of Corporate Officer, Owner, or Designee <br />~~ -R-~ ~ <br />Date <br />~s <br />