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<br />iii iiiiiiiiiiiu iii <br />999 <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Grand Junction Pipe & Supply Co. <br />M-1998-084 <br />Whitewater Pit <br />January 7, 2002 <br />DEC 2 8 2001 <br />DlYision of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />~~'o <br />According to C.R.S. 34-32.5-1 l6 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall 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 to occur <br />during the upcoming year, reclamation [ha[ will be performed during the coming year, [he dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual resort and annual resort maa to this form. Please note that att <br />adequately labeled mnp that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate [he following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Edward J. Settle <br />Permittee Name: Grand Junction Pipe & Supply Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4604 <br />Fax Number: (970) 243-6703 - - - - - - - <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 enclosed. <br />~ <br />Signature of orpomte Officer or Owner <br />(Q _2L- 2vo <br />Date <br />M 1PERMmMASTERD000MEMS~hLAF~01 <br />