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C6 ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Yust Ranch <br />M-2000-014 <br />Yust Ranch Gravel Pit <br />May 22, 2005 Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Grand <br />RE~EIVI~® <br />MAY20~ <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operator <br />--shall submit.the_annual-fee,-a_report_and~map_showing.the_extent_of_currenLdisturbances_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 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 ynnr revised written anm.al report and anm~al report man to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sujf:ce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jim Yust <br />Permittee Name: Yust Ranch <br />Address: Box 246 881 Grand County 1 <br />Kremmling, CO 80459 <br />Phone Number: (970) 724-3578 <br />Fax Number: <br />If you have additional comments and/or information [hat 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 />Owner, or Designee <br />Date <br />