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• <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Telluride Gravel, Inc. <br /> PERMIT NO.: M-1976-032 <br /> OPERATION NAME: Alexander Pit <br /> ANNIVERSARY DATE: fag ` June 17,2001 <br /> ANNUAL FEE DUE: [00 $ .00(Due on or before your anniversary date) <br /> COUNTY: San Miguel <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 <br /> operator shall submit the annual fee, a report and map showing the extent of current disturbances to a�ffected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances that are anticifdated to <br /> occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br /> beginning of active operations, and the date active operations ceased for the year, if any. <br /> Please attach your revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled Wrap that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: I <br /> Pennittee Contact: David Ballode <br /> Permittee Name: Telluride Gravel, Inc. <br /> Address: 270 Hwy 625 <br /> Telluride, CO 81435-9144 <br /> Phone Number: (970) 728-3775 <br /> Fax Number: (970) 728-3015 <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 <br /> enclosed. <br /> 7L) / <br /> Signature of Corporate Officer or Owner RECEIVED <br /> Dale <br /> JUN152001 <br /> Division of Minerals and Geology <br /> M'TERM1PMASTE RDOCUMENTS W-AF-01 <br />