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<br />ANNUAL REPORT <br />PERMITTEE NAME: Tri-County Gravel <br />PERMIT NO.: M-77-205 <br />OPERATION NAME: Tri-County Gravel <br />ANNNERSARY DATE: November 29, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Delta <br />• ~II ~I~~I~II~~~~~ ~I~ <br />sss <br />~~ <br />~~, <br />~~~ <br />~~GV ~~ 1°'°~~ e~~ <br />~~ ~~`~ <br />,`~~ <br />According to C.R.S. 34-32.5-] 16(31(x), each year; on [he anniversary dare of [he permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report maa and written resort to this annual report. P/erase <br />note thnt nn adequately lnbeled map thnl clenrly delineates and inchides the nbove elements Wray <br />since for n written report. 7j'/a,~ ~~~ Qitea -~-~-~ 0 °'~ <br />p O _ u,. ~n-o r~c.n yy.~((ll. ~... ;2~Ly+..~s- ~~ . <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: /ery~/ ~ ~`"'t Company: ~.~-% ~~'~'"~r .~cY+~~ <br />Adddress: ~~ /~i~S66 Phone No.: (970) gr~ - -~~y i <br />9S6R J T~i3r <br />_~_ ~' 8' l K t 9 Fax No.: (9.`b) X 7?- 3 7 9 2 <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 form along with your map and/or written <br />report. <br />Signature of Corporate Offi r, or Owner Date <br />INSTRUCTIONS ON BACK <br />