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06!11/2006 23:15 9706752702 ACE WEST PAGE 02!03 <br />PERNIlITEE NAI~IE: <br />PERMIT NO.: <br />OPERATION NAMP: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTX: <br />Ceeil C Powell <br />M-1995-012 <br />PoweA's Gravel Pit <br />May 12, 2006 <br />$x81.00 (Doe oa or before your aonirversary date) <br />Moffat <br />According to C.R.S. 3432.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operator <br />shall submit the atmual 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 begimung <br />of active operations, and the date active operations ceased for the year, if any. <br />P1en~~nftn~h xnnr revised written annnnl rennrt and annnnl roonrt my~ to this fnrm_ Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may su,~tcefor a written report. <br />Division records indicate the following perncittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: <br />Perrriittee Name: <br />Address: <br />Cecil C. Powell <br />Cecil C Powell <br />P.O. Box 23 <br />Dinosaur, CO 81610 <br />Phone Number: (970) 37Q-2329 <br />Fax Number: <br />If you have additiottal 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. Amtual Report instructions sire enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />s <br />Aare <br />