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<br />ANNUAL REPORT <br />PERMITTEE NAME: Conejos County <br />PERMIT NO.: M1987097 <br />OPERATION NAME: La Florida Grav Pit <br />ANNIVERSARY DATE: August 18, 1999 <br />ANNUAL :FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Conejos <br /> <br />?ECEIVED <br />~r gym, <br />~ ..;i ~~. <br />,v:;~on of Minerab & Geology <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclattiation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcotning year, reclamation that will be performed during [he coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the <br />year, if any. <br />Please attach vour revised annual report map and written report to this annual report. Pleo.re <br />note lhrrt nn adequnte(y lnbelerl mnp tlmt dearly delineates curd includes the above elements nuns <br />suffice for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />ContactName:~~e (~ Z~~YN~"r~ <br />Address:? ~ /~JOX /s7 <br />~J yr~~, G~ ~ ~~~ a ~ <br />Company: W ~ <br />Phone No.: (7A) 7~0 - 5~7~- <br />Fax No.: (~) ,3JG - ~~ 6 / <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report forth along with your map and/or written <br />report. <br />~~ ~~~ ~' <br />Signature of Corporate Officer, or Owner Dale <br />INSTRUCTIONS ON BACK <br />