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ANNiiAi. FF.F, and RF.P(lRT RF.OiTF.ST <br />A .>n, '^'~n s'an~ <br />PERMITTEE NAME: Gary K. and Sarah L. McNulty <br />PERMIT NO.: M-1980-003 SAN 3 1 y~r <br />OPERATION NAME: McNulty Cinder Pit Division of Minerals and Geology <br />ANNNERSARY DATE: January 23, 2005 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Eagle ` y S~ <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 operator <br />_--...`Shall submit the ar~~l~eg,~.Senort and man s1Lw;n~o t>,e_~tent~-~~~rr nt distuxbancPC~tn 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 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 ~nnr revised written anneal report and anmial report main to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Sarah L. McNulty <br />Permittee Name: Gary K. and Sarah L. McNulty <br />Address: 7747 CR 100 <br />Qw.uvCtY C~~le S G.LL~ <br />1'I 4'I Coda t-I 2Df} J t oc7 <br />(~gR6ont t7Rt_~ CO. fitbZ3 <br />Carbondale, CO 81623 <br />Phone Number: (970) 963-4829 <br />Fax Number: (970) 963-4829 <br />q`-o g6`3 43 63 <br />SQ M E <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 />c ~ ~.Gtbt~ V 4~M~u1tfL/ <br />Signature of Corporate`Officer, Owner,-br Designee <br />'1 ~` / <br />Date <br />