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.,~ ~--.. <br />- ,`t./ <br />~v <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Ouray County <br />M-1975-268 <br />Dallas Gravel Pit <br />March 22, 2004 <br />$688.00 (Due on or before your anniversary date) <br />Ouray <br />MAR 15 2004 <br />Division of Minerals & GeoloBY <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />- - -lantt,-reclamation-accamplished-to date-and-during the-preeeding-year, new disturbances-that-are-anticipated-to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates far the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual ~7nrt and annual re,~nrt ml~ to Chic form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bob Wolford <br />Permittee Name: Ouray County <br />Address: P.O. Box 456 <br />Ridgway, CO 81432 <br />Phone Number: (970) 626-5391 <br />Fax Number: _ (970)_626-0439 <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 farm along with your written report and map. Annual Report instructions are <br />enclosed. <br />~~sf1y'Z/ ~~~~<--ze' <br />Signature of Corporay Officer, Owner, or Designee <br />/~/©~r <br />Dam <br />MiPERMI7IMASTERDOCUMEM5Vv1-AF-04 <br />