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<br />ANNUAL REPORT <br />PERMTTTEE NAbIE: Jackson County <br />PERMIT NO.: M-78-266 <br />OPERATION NAME: Riley Gravel Pit <br />ANNIVERSARY DATE: August 1S, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Jackson <br />III IIIIIIIIIIIII III <br />999 <br />u°DD DDD <br />)i~~ . 1 <br />sr°~o~M,~~~ 'g~9 <br />G~y~y <br />According to C.R.S. 34-32-116(3)(a), 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 <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during [he 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 report map and written report to this <br />annual report. Plense note that nn adequately lnbeled mnp that clenrly 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: /7~i~r'(OLtI S G~EI' Company: VACr1 SOGV~ COI)/l// `~ <br />Address: ~d, BMX .L~QQ PhoneNe.: ( 9~~) 723'- l,~I~g~ <br />~/a~1~~~CC2~ n Fax No.: ( 970 > 723 ~ 1f 70~ <br />SOS 8'O <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 />I / ~f <br />Signature of orpo ate Officer, or Owner Date <br />~~ <br />INSTRUCTIONS ON BACK <br />