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.,~: <br />• <br />ANNUAL REPORT <br />PERMTfTEE NAME: Baca County <br />PERMTI' NO.: M-77-479 <br />OPERATION NAME: Gravel Pit No 2 <br />ANNIVERSARY DATE: September 11, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Baca <br />~ III IIIIIIIIIIIIIIII <br />® 11® <br />RECEIVE <br />AUG 0 3 1999 <br />~: ~:~+~sun of Minerab 8 Geology <br />According [o C.R.S. 34-32-11(i(3)(a), each year, on the a;miversary date of the perrrtit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during [he preceding year, new <br />disturbances that are anticipated to occur during the upcoming yeaz, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual reuort mau and written report to this <br />annual report. Please note that an adequately labeled map that clearly delineates and <br />includes the above elements may suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: RAY MILLER <br />Address: 741 MAIN STREET <br />SPRINGFIELD, CO 81073 <br />Company: BACA COUNTY <br />Phone No.: ( 719 ) 523-6532 <br />Fax No.: ( 719 ) 523-6584 <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />r e /7l2'~ 7 • ~O / 9 <br />Signature of Corporate Offio r, o • Owner Date <br />INSTRUCTIONS ON BACK <br />