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>~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNi-JAL FEE DUE: <br />COUNTY: <br />1/ ANNi1AI, FF.F, and RF,PORT RF,{~iTFST <br />j/ Alamosa County <br />/M-2001-108 <br />Alamosa County Pit No. 1 <br />February 22,2006 <br />RECEIVED <br />`' FEB 19 2006 <br />~Diwuon of Mmsroln and 6eobgy <br />$281.00 (Due on or before your anniversary date) <br />Conejos <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 />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming yeaz, 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 khe year, if any. <br />Please attach ynnr revised written anmial reRnrt and annnal re~orf mapJn this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Phil West ~'~~~ <br />Permittee Name: Alamosa County =-~~ <br />Address: 8663 S. CR 109 L-----" <br /> L__---- <br /> Alamosa, CO 81101 °---""'~ <br />Phone Number: (719) 589-6262 ~~' <br />Fax Number: (719) 589-6063 `--'~- _-- <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 farm along with your written report and map. Annual Report instructions are <br />enclosed. <br />~~~ <br />Signature of orp/orate Officer, Owner, or Designee <br />v/ ~ ~~ <br />Date ~ <br />M:~PERMIThfASTERDOCUMENTSN1-AF-04 <br />