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l~ <br />~CO <br />PERMITTEE NAME: Rio Graude County <br />PERMIT NO.: M-1978-071 ` ' ~ ~ ~~ ~ ~: <br />OPERATION NAME: Del Norte Gravel Pit <br />ANNIVERSARY DATE: November 25, 2004 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 12io Grande <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 <br />operator 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 tL•afare anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ym~r revised written annual re~nnrt and annual re on rt maTtn this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Lawrence "Buddy" Shaver <br />Permittee Name: <br />Address: <br />Rio Grande County <br />168 N. Washington <br />Monte Vista, CO 81144 <br />Phone Number: (719) 852-4781 <br />Fax Number: (719) 852-0305 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />S~ of„ Officer, Owner, or Designee <br />~~ z2t~y <br />Date <br />M:~PERMITUTASTERDOCUMENTSNI-AF-04 <br />