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/us <br />(~ ANNTiAi. FF.F. and RF.PnRT RF.niiF.ST RECE9~lED <br />PERMI ITTEE NAME: ~ Van Valkenburg Cattle Company, LLC ~ APR 2 0 2006 <br />PERMITIiI NO.: / M-2005-003 '~ Givisioa of Minerals and Geology <br />OPERATION NAME: v Van Valkenburg Gravel Pit <br />ANNNERSARY DATE: May 11, 2006 <br />ANNUiL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTil': Jackson <br />Accordiflg to C.R.S. 34-32.5=1 t6 or C.R.S. 34-32-1 l6, each year, on the anniversary date of the perinit, ari operator <br />shall su~mit the annual fee, a report and map showing the extent of current disturbances to affected land, <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 />ch ymrr revised written annual re~nnrt and annnal re~nrt maz to this form- Please note that an <br />labeled map that clearly delineates and includes the above elements may since for a written report. <br />records indicate the following permittee contact information. Please verify and make any necessary <br />Contact: Wiliam Van Valkenburg <br />Name: Van Valkenburg Cattle Company, LLC <br />12353 Hwy 14 <br />Walden, CO 80480 <br />Phone N~umbei: (970) 723-4346 ~ ~ _ _ <br />Fax Number: _ ~ (970) 723-4346 _ <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below orb attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />`N '-GM'` ~'!/o-,~ <br />L~ <br />Signature of Corporate Off r, Owner, or Designee <br />--- !~ <br />