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i <br />~i <br />ANNUAL REPORT <br />PERMITTEE NAME: Rio Blanco County <br />PERMIT NO.: M-98-054 <br />^CCEIVEo <br />~., a 1 G 1599 <br />,,. 9 ~ Geoto9Y <br />OPERATION NAME: East Douglas Creek Gravel Pit <br />ANNNERSARY DATE: October O5, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 ~® ~ ~'- <br />COUNTY: Rio Blanco <br />- --' according to C12.S. 34-~-1 lb(3j(aj, each year,-on t-Tie anniversan~ date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to 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 year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note drat an ndegaately labeled map dial clearly delineates and <br />inclesdes the above elements may since for a x~ritten report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name:~Y.~tir.,,,~~ ~synussc/1 Company:~t'n /~,CanrO ~~uitty <br />Address: / ~ ~ ~ ~ ~(y f/ L4/~Si (i~ Phone No.: (9 `~~) / 9S -" ~l'l ~f <br />! ~ o%,P,~,/a $i,/~yQ Fax No.: ( 970) Cgs- S.~ I/ <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it to this report form along with your map and/or <br />written report. <br />Signature o orporate Officer, of Owner Date <br />s <br />INSTILUCT/ONS ON BACK <br />