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APR-21-04 11:16 FRDM-Colorado Division of Minerals 8 Gealopy +13036663567 T-37A P.002/002 F-353 ~ / <br />~~ STATE OF COL Rf~DO <br />DIVISION Of MINERALS AND GEOLOGY <br />Department of NatL,ral RC5UUK2S ~ L <br />7373 Sherman Sc, Room fly <br />Denver, Coloreds 80203 <br />Phone: (303) 86Cr3567 <br />F>i~T!6NA,ME: <br />PERMIT NO.: <br />OP8R4'XTON NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />Lee Roy and Marlene S Rothe RECEIV ED <br />U~-X995-017 <br />Rothe Sand & Gravel Pit <br />December 18, 20D3 <br />APR 2 22004 <br />Ditision at L. - -- <br />S28X.00 (Due on or before your anniversary date) <br />COLORAf~O <br />D I v 15 I O N O F <br />M T N &RA X. 5 <br />GEOLOGY <br />PECLAHATION•HIN INC <br />Sgi6TY-6CIFNCE <br />sill ovens <br />Gwemor <br />Russell George <br />Executive DireRw <br />Ronald w. G~gany <br />CO~N~hY: TAgan DiviSipn Dirrgpr <br />Nazural Resowce Truuew <br />According to C.R.S. 34-3Z.5-116 or C.1ZS. 34-32-11G, each year, an the amlivetsary date of 1Jae permit, an operator <br />shall submit the almost fee, a report and trap showing the extent of current disturbances to affected ]and, <br />reclamation accomplished tp date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamarion that will be performed during the coming year, the dates for the beginning <br />of active operatiotL~ and the date active operations ceased for the year, if any. <br />Please attach ymn• reused written anneal re~nrt and anneal rro~rt maQ to this form. Pjgate note that an <br />adequately labeled map that clearly delineates axd includes the alwve elements may .suffce,for a writters report. <br />Division records indicate the follow4ng permittee contact informarion. Please verify and make any necessary <br />changes: ~y ,,,sn <br />Petmittee Contact: Lee Roy Rothe ~It~'/ ~'"~-"=" ' .f Lill. 0'1 , / <br />Permittee Name: T.ee Ttoy and Marlene J Rothe / \,/~,"~~~~ ~ T <br />Address: 19727 Factory St. <br />Sterling, CO 80751 <br />Phone Number: (97D) 522-2281 <br />Fax Number: (970) 522-2282 <br />ff you have additional conmtents and/or information that should }w provided to the Division, please provide it <br />heIow or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signah~a-e of Corporate~Q F'ecr, Owner, or Designee <br />~, - ~/ ~y <br />IS:~PERhII1,MA5[mnOCtR+,E2rMM-AFat <br />Office of Office o! <br />Mined Wed Reclamation A[tive and InRdive Mines <br />Colorado <br />Geological Survey ~~ <br />RPR-21-2004 WED 10:02RM ID: PRGE:2 <br />