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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 />1 ~J <br />United Companies of Mesa County t~ E C E I V E D <br />M-1988-037 <br />United/Norwood Pit <br />~=';~tY 2 3 2002 <br />May 25, 2002 Jivisinn of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Montrose <br />cv <br />9 <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 [he ex[ent_of_current_dis[urbances_to_affected-]and, - <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 annual report and annual resort mau to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permi[tee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Richard Johnson <br />Permittee Name: United Companies of Mesa County <br />Address: P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Numbet: (970) 243-5945 <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 enclosed. <br />Signature of Corporate Officer or Owner <br />l~-t Z!. Z~2 <br />Date <br />M?PERMn1MA5TERDOC UMENTSN~I-AF-01 <br />