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~e <br /> RECEIVED <br /> ANNiiAi, FF.F, and RF.P(1RT RF.OiIF,ST <br /> JAN 2 2 2004 <br />PERMITTEE NAME: Hardrock Sand and Gravel Division of Minerals & DeoloBY <br />PERMIT NO.: M-1990-140 <br />OPERATION NAME: Martin Pit 1-A <br />ANNIVERSARY DATE: December 18, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <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 />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 xpnr revised written annnal rennrt and annual report ma,~ to this form. Please note thal an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Pat J. Weber <br />Permittee Name: Hardrock Sand and Gravel <br />Address: P. O. Box 141 <br />Craig, CO 81626 <br />Fax Number: (970) 824-4@~3~ <br /> <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 />lf/~ <br />Si ature of orporate Officer, Owner, or Designee <br />/ - /9 -a~f <br />Date <br />6¢S~` ~B6'!~/1 <br />M1PERMINNASTERD000MENTSUI-AF-01 <br />