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APR.12.2201 12:54AM DIV/MINERAL58,GEOLOGY _ I NO.E24 P,3i4 <br /> III IIIIIIIIIIIII III <br /> 999 <br /> A K—NVAL M and REPORT REQUEST <br /> RECEIVED <br /> PE MMFE NAME: Raymond C.Petersen <br /> PERMIT NO,: M-1981-236 APR 13 2001 <br /> OPERATION NAME: Colorado River Ranch Gravel Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: March 29,2001 <br /> ANNUAL FEE DUE: $689.00(Due on or before your anniversary date) <br /> COUNTY: Grand <br /> According to C.RS. 34-32.5-116 cr C.R.S. 34.32-116, each year, on the anniversary date of the permit, an <br /> operator shall submit the annusl fee, a report and map showing the extent of current distuftnees to affected <br /> land, reclamation acoompli?bed to date and during the preceding you.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 aatrve operations,and the date active operations ceased for the year,if any. <br /> Phase attach Your rm*M gritter annual report and annual report man to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may sujftce for a written <br /> repom <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Raymond C.Petersen <br /> ParmitteeName: Raymond C.Pemrson <br /> Address: P.O,Box 832 <br /> Rremmling,CO 90459 <br /> Phone Number: (970)724.9327 <br /> Fax Number; (970)724.9327 <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 /> i <br /> w <br /> ,S gnanue of Corp e O cer or Ovvnor <br /> nD��V <br />