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hhp <br />RECE6Ql~r°, <br />JAN 2 3 2006 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />v ANN1iAi, FF.F, and REPORT RF.OilF,ST <br />/ Geroux Gravel <br />M-2000-059 <br />t/ Geroux Gravel <br />February 22, 2006 <br />$281.00 (Due on or before your anniversary date) <br />Custer <br />t/givision of Minerals and Geology <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 />--~+all-submit-the-erertual-fee-a-repo~2nd-map showing-the -exien?-ef=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 anneal reQnrt and anneal re~nrt man 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: Darrell Geroux <br />Permittee Name: Geroux Gravel <br />Address: 1100 CR 160 <br /> Westcliffe, CO 81252 <br />Phone Number: (719) 783-2709 <br />Fax Number: - (719) 783-2709--~ <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 />~~P~-~~ C9fu~t2f^' <br />Signature of Corporate fficer, weer, or Designee <br />1~2.®~ 4 ~ <br />Date <br />