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• ~~I II~~I~~I~~~~~ ~I~ <br />~ . 999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Latimer County <br />PERMIT NO.: M-1985-135 <br />OPERATION NAME: Horton Gravel Pit <br />ANNNERSARY DATE: January 31, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Latimer <br /> <br />®® <br />®® <br />\~-,v <br />,Pa1~ ~~e <br />\~\~ .° <br />0 <br />Os'~~ <br />Accurding to C.R.S'34-32=11G(3)(a7-each year, on the anriive~s"ary date of [he permit, an - '- - <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />[o affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming yeaz, the dates for the beginning of active operations, and [he date <br />active operations ceased for the yeaz, if any. <br />Please attach your revised annual report map and written report to this annual report. <br />Please note that an adequately labeled mnp chat clearly delineates and includes the above <br />elemenls mny suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: ~` ~j \ <br />Contact Name:QE~ ~1\s ~ . \"\OR0.\SO.> Company: ~PR\Ht.R Geo..~ti ~~,~iJ6F. <br />Address:Q ~.~esx \\q0 Phone No.: (°x`10 )y~~' S6~~ <br />C.o~t\a~t C-~ 4~52.Z'~~gC~ FAX No.: (°x`10 )'=.z.~ - o~.'~~ <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a sepaza[e sheet and attach it to this report form along with your map and/or <br />written report. <br />O~ <br />S aa. ~ ~ 'z.T moo <br />Signature of Corporate Off`i r, or Owner Date <br />INSTRUCTIONS ON BACK <br />M: W ER M f I V.1 A STE R DOC U M E NTSU1 ~ AF-03 <br />