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<br />PERMITTEE NAME: Grand Junction Pipe & Supply Co. REC+E~ VED <br />PERMIT NO.: M-1979-089 JUL 1 1 1003 <br />OPERATION NAME: 23 Road Pit <br />Division of Minerals and Geoto'y <br />ANNIVERSARY DATE: July 25, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br />According to C.R.S. 34-32.5-I 16 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 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 ynnr revised written anneal rennrt and anneal rennrt m ~n to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Edward J. Settle <br />Permittee Name: Grand Junction Pipe & Supply Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4604 <br />Fax Number: (9701 243-6703 <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 orporate Officer, Owner, or Designee <br />l7- z6O3 <br />Date <br />MiPERMITNIASTERDOCUMENTSUI-AF-01 <br />