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~' cb ~ <br /> AN~NIiAi. FF.F, and REPORT RF.Oi1F,ST <br />PERMITTEE NAME: ogan County <br /> L~ <br />PERMIT NO.: l/M-1998-249 <br />OPERATION NAME: Kokes Gravel Pit <br />ANNP/ERSARY DATE: October 1, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, 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 active operations, and the date active operations ceased for the year, if any. <br />Please nttach ynnr revised written annual rennrt and annual re nr~~t_map to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changers: <br />Permittee Contact: Byron D. Hickox UU.57/I'~ S. ~ ~l[5//79i (~ <br />Permittee Name: Logan County <br />Address: 315 Main St., Ste. 2 <br /> Sterling, CO 80751 <br /> <br />Phone Number: <br />(970) 522-0888 (~ > l q <br />7 / Q S ~ d " 7 ~' 7 / , <br />Fax Number: (970) 522-4018 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it [o this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />~~~ i ~ / <br />Signahxr o rate Officer, Owner, or Designee <br />9-~ D - ~_S <br />Date <br />M:NERMI'rNrASTERDOCUMENTSVN-AF-04 <br />