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• III IIIIIIIIIIIII III ~ ~~~ 7~°~ ~$~°~ ~~ <br />999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Andesite Rock Company <br />PERMIT NO.: M-1988-048 <br />OPERATION NAME: Carr Gravel Resource <br />ANNNERSARY DATE: September 22, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $688.00 <br />COUNTY: Weld <br />ScP 2 5 20DD <br />Division of Minerals and Geology <br />According to C.R.S. 34-32-116(3)(a), each yeaz, on the anniversary date of the permit, an operator shall <br />submit the annual tee, a report and-m`ap showing the extent of cuiient disturbances to affected land, <br />reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that an adequately labeled map that clearly delineates and includes the above elements may <br />sufj`ice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: ~.n ~ <br />Contact Name: ~-yN N ~'^ppp`~~ Company: AN~~ SI TE ~iflli~ (~~7'r~ <br />Address: ~]~Z I t; /1~~`" nNC . Phone No.: (~.3D3) Z~ y~~ ~ <br />S ulTt= 2cx~ FAX No.: (303 , 2.£S9 l3~/~ <br />~-~~Mr7Z,S'D/J ~ 8U6~(p e-mail: <br />If there aze a pion comments and/or information that should be provided to the Division, please <br />provide i n a s ate sheet and attach i[ to this report form along with your map and/or written <br />report. <br />9~~v~' <br />Sign o Corporate Of tcer, or Owner Date <br />INSTRUCTIONS ON BACK <br />Al ~PERMIilh1ASTERD000SiEKI'SU1~AF-01 <br />