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<br />~ RECEIVED <br />PERMITTEE NAME: Geroux Gravel <br />PERMIT NO.: M-2000-059 FEB 18 2003 <br />OPERATION NAME: Geroux Gravel Division ~f Minerals and Geology <br />ANNIVERSARY DATE: February 22, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Custer <br />According to C.R_.S. 34-32.5-116 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 />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anneal rennrt and anneal report 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 pemuttee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Darrell Geroux <br />Permittee Name: Geroux Gravel <br />Address: 1100 CR 160 <br />Westcliffe, CO 81252 <br />Phone Number: (719) 783.2709 <br />Fax Number: (719) 783-2709 <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 />Signa~tyure of Corporate Officer, Owner Designee <br />.-L/~ 2i /~ ~i <br />Date <br />M:~PERMITU-tASTERDOCUMENTSVd-AF-01 <br />