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i\ <br />, <br />AN1 III IIIIIIIIIIIIIIII ®. <br />_~ <br />PERMITTEE NAME: Do le J Russell ~?~{i~~UtL' ®~ <br />Y <br />PERMIT NO.: M-1994-096 ApR 17 2000 <br />OPERATION NAME: Russell Gravel Pit p;visicnofMinetals&Geoiog7 <br />ANNNERSARY DATE: April 14, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 <br />COUNTY: Latimer <br />According to C.R.S. 34-32-116(3)(a), each yeaz, on the anniversary date of the permit, an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated <br />to occur during the upcoming yeaz, reclamation that will be performed during the coming yeaz, the <br />dates for the beginning of active operations, and the date active operations ceased for the yeaz, if any. <br />Please attach your revised annual resort maa and written resort to this annual report. Please <br />note that an adequarefy labeled map that cfearly delineates and includes the above elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: is l Q d V S 4 I[ des ~ ~~ <br />~- <br />Address: 1,1. ~ 3 D !~ C. /~ Q <br />f;J ~~ I ~~ .~.o K ~(+ o g o s~lg <br />Company:~uSSC~/ fn r4 y~~ P~~ <br />Phone No.: (47~) S~ ~' ~~oi~/ <br />FAX No.: (970) /r~i 8'' 7~o~d <br />If there aze additional comments and/or information that should be provided to the Division, please <br />provide it on a sepazate sheet and attach it to this report form along with your map and/or written <br />report. <br />~{-/3-dd <br />ignature of orporate Offi er, or Owner Date <br />INSTRUCTIONS ON BACK <br />M~PERMrM1A5TERD000MEMNA-AF-01 <br />