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<br />ANNUAL FEE and REPORT REQUEST RECEIVED <br />PERMITTEE NAME: Valco Gunnison Concrete Division ~~T Q ~ 202 <br />PERMIT NO.: M-1978.287 Division of Minerals anal Geology <br />OPERATION NAME: Vader Pit <br />ANNNERSARY DATE: October 5, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Gunnison <br />According to C.R.S. 34-32.5-I l6 or C.R.S. 34-32-176, each year, on [he anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, ti <br />- 7edamation accomplished to date and during the preceding year, new disturbances that ace anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach pour revised written annual report and annual report map to this form. Please note That an <br />adet7uarely labeled map that clearly delineates mtd includes the nbove elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessazy <br />changes: <br />Permittee Contact: Ed Stewart <br />Permittee Name: Valco Gunnison Concrete Division <br />Address: P.O. Box 837 <br /> Gunnison, CO 81230 <br />Phone Number: (970) 641-095] <br />Fax Number: (970) 641-0954 - <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~,~~.,-_ <br />Signature of Corporate Officer, Owner, or Designee <br />\ o - ~~~, <br />llate <br />A7 NF.2M1'MIASTGRD000hIGNT$VN-AI~-01 <br />