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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Grand Junction Pipe & Supply Co. RECEI VET <br />PERMIT NO,: M-1979-089 JUL 12 pppp <br />OPERATION NAME: 23 Road Pit Diuisian of Minerals and Geology <br />ANNIVERSARY DATE: July 25, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br />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 vour revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may st~ce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Edward J. Settle <br />Pertnittee Name: Grand Junction Pipe & Supply Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4604 <br />Fax Number: (970) 243-6703 <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 />~~~~-d+' <br />Signature o Corporate Officer or Owner <br /> <br />Date <br />M:~PERM17 WIASTERDOCUMENTSVN-AF-O7 <br />