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<br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: Logan County <br />PERMIT NO.: M-1983-187 DEC 0 9 2002 <br />OPERATION NAME: Kues Gravel Pit Division of Minerals and Geology <br />ANNIVERSARY DATE: November 8, 2002 <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-]16 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 />:and,-reclamation-accomplished to date-and-duriug'thz preceding year; new disturbances that are anticipated To <br />occur during [he upcoming year, reclamation that will be performed during the coming year, the dates for [he <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual resort and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice fora written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: 4~en-Strelrsen ~>7~1G~01( <br />Permittee Name: <br />Logan County <br />Address <br />315 Main St. <br />Sterling, CO 80751 <br />-Phone Number:- ` (970) 522-0888 <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 to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signa re)of Corporate Officer caner, or Designee <br />Date ~ <br />M:tPERMITMASrERDOCUMENiS~M-AF-df <br />