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<br />- <br /> ~ <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />OCT 0 9 2001 <br />Division of Minerals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Valco Gunnison Concrete Division <br />M-1978.287 <br />Vader Pit <br />October 5, 2001 <br />$ti88.00 (Due on or before your anniversary date) <br />Gunnison <br />According to C.R.S. 34-32.5-1 ] 6 or C.R.S. 34-32-1 16, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <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 reuort and annual report mao to this form. please note that mt <br />ndequntely labeled map that clearly delineates and inchtdes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permi[[ee Contact: Ed Stewart <br />Permi[[ee Name: Valco Gunnison Concrete Division <br />Address: P.O. Box 837 <br />Gunnison, CO 81230 <br />Phone Number: (970) 641-0951 <br />Fax Number: (970) 641-0954 <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 />~~~ <br />Signature of Corporate Officer or Owner <br />~h- S-O~ <br />Dale <br />M ~PERMn4MASTERD000MEM'SN1-AF-01 <br />