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g. w.i v:.ii ~~O~U .~. ~.N b ~~J <br />?005 <br />~~ ~ ~~~~ <br />ANNi1AI. FF.F, and RF.Pt7RT RF.t7iiF.ST <br /> <br />PERMITTEE NAME: "E~am Construction, Inc. <br />PERMIT NO.: M-2002-111 RECEI V E® <br />OPERATION NAME: Gilsonite Gravel Pit <br />"CT' ' <br />ANNNERSARY DATE: October 21, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary datDjwision of Minerals and Geology <br />COUNTY: 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 the permit, an operator <br />shall submit-the annual-fee~a-repent and-map-sh4wang-the-extent of current disturbances tn-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 annnal re~nnrt and anmral re~nrf man to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Harold F. Elam <br />Permittee Name: Elam Construction, Inc. <br />Address: 1225 S. 7th St. <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-5370 <br />Fax Number: (970) 245-7716 <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 />~r op C~i<r ~c~.no-y ci- <br />igna~• f Corporate O er, Owner, es~gnee <br />/0-7-0 <br /> <br />Date <br />