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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Parkerson Construction Co. <br />M-1986-160 <br />Sunny Side Gravel Pt <br />February 17,2004 <br />,~~ ply <br /> <br />RECEIVE® <br />FEB 0 9 2004 <br />Division of Minerals & Geolop~ <br />$281.00 (Due on or before your anniversary date) <br />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-sabriiit the-annual-fee a-report-and map-~srowing_the extent of cwrent`disturbances to affected ]arid, <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 your revised written anmial report and anmlal 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Alan Parkerson <br />Permittee Name: Parkerson Construction Co. <br />Address: 710 S. 15th St. <br />Grand Junction, CO 81501 <br />Phone Number: (970).242-8134 - . <br />Fax Number: (970) 242-8977 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with yow written report and map. Annual Report instructions are enclosed. <br />~~ ~~ <br />Signature of orporate Officer, Owner, or Designee <br />//~~Q 3 <br />D tae <br />M:IPERMINNASTERIbCUMENTSUI-AP-01 <br />