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~xS <br />6~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />James H & Kathleen H Ross <br />M-1990-134 <br />Ross Pit <br />~~~~' ~~® <br />MAY ~ 61005 <br />April 10, 2005 Oivisin~ ut Minerals and CeoloBY <br />$281.00 (Due on or before your anniversary date) <br />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 />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />- - reclamation°accomplishz-il to date-and during the-preceding"year,`riew disturbances that are ariticipated`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 your revised written annnal report and anm~al report maw 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 permittee contact informafion. Please verify and make any necessary <br />changes: <br />Perruittee Contact: Bud Bower <br />Permittee Name: James H & Kathleen H Ross <br />Address: 595 Taylor St. <br />Phone Number: <br />Fax Number: <br />Craig, CO 81625 <br />(970)824-2793 <br />(970)824-9410 <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 />Signature of Corporate Officer, Owner, or Designee <br />~-~-moo SJ <br />Date <br />Q YYl ~~ ~I ~ n~ -j o o ~( <br />~~~~ ~V1 2-00 ~ <br />d 2_ ~~~cl~m~~~ ova - <br /> <br />