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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Parkerson Construction Co. <br />M-1986-160 <br />Sunny Side Gravel Pt <br />February 17,2002 <br />$281.00 (Due on or before your anniversary date) <br />Mesa <br /> <br />RECEIVED <br />FEB 191002 <br />Division 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 />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />-` -reclamation accomplished-to date and during the preceding year,-new dismrbances'tharare anticipated-to-occur-= <br />during the upcoming year, reclamation that will be performed during [he 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 your revised written annual report and annual report map 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 permit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact; Alan Parkerson <br />Permiitee Name: Parkerson Construction Co. <br />Address: 710 S. 15th St. <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-8134 <br />__Fax Numbers X970) 242-8977 _ ~ - _ ,_ _ _ __ __ _ _ _ ___ _ <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ to this form along with your written report and map. Annual Report instructions are enclosed. <br />~~. <br />Signature of orporate.Officer or Owner <br />Date <br />M:~PERM IIT\MASTERDOCUMENTSVvI-AF-OI <br />