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~~ <br />1 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Grand County <br />M-1984-156 <br />Grand Cnty No 201 aka Scholl Gravel Pit <br />May 29, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Grand <br />RECEIVED <br />APR 2 2 2002 <br />Division el Minerals and Geology <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on [he anniversary date of the petntit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />- __ _land, reclamation accomplished to_date and during the preceding yeaz,_new_discurbances that_are anticipated-to__ <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report mau to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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-. M C. Branstetter <br />Permittee Name: Grand County <br />Address: 467 E. Topaz Ave. <br /> P.O. Box 9 <br /> Granby, CO 80446 <br />Phone Number: (970) 887-2 ] 23 - - <br />Fax Number: (970) 887-3168 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ [o this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />~~~G~ <br />Signature of Corporate Officer or Owner <br />/ ~/ <br />Dale <br />M iPERM ITNIASTERDOCUMENTSUI-AF-OJ <br />