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r~, o t~ <br /> <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Parkerson Construction, Ine. <br />M-1987-178 <br />31 Road Pit <br />February 12,2004 <br />FEB 0 9 2004 <br />Division of Minerals & Geology <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of tl}g permit, an operator <br />shall_submit_tha_annual.fee, areport and map showing the extent of current disturbances-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 annual rennrt and annual re n~ rt m8n 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: Alan Parkerson <br />Pennittee Name: Parkerson Construction, Inc. <br />Address: 710 S. 15th St. <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-8134 _ _ <br />-Fax Num[ier' - ~ (970) 242-8977 ~y <br /> <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 />Signature of orporate Officer, Owner, or Designee <br />i/~/ z <br />M:VPERMITMASTERDOCUMENTSNr-AF-0I <br />