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;~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Glenn E. Sessions & Sons, Inc. <br />M-2003-058 <br />Fairbanks Pit <br />December 4, 2004 <br />$281.00 (Due on or before your anniversary date) <br />Jackson <br />N <br />r~~, ~~}`~i,J4 <br />,, c+, <br />~. ?~elcp" <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 />°'-'-~reciamatiori accomphsh`edto date and-during the preceding year; new disturbances that are anticipated to occur -- <br />during the upcoming year, reclamation that will be perforated 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 ymtr revised written annual re~nrt and anneal rennrt m ~n to this form- Please note that 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: Ronald F. Sessions <br />Permittee Name: Glenn E. Sessions & Sons, Inc. <br />Address: 33442 Hwy l25 <br />P.O. Box 1076 <br />Walden, CO 80480 <br />Phone Number: (970) 723-4944 <br />Fax Number: (970) 723-8344 __ <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 />~~t~~ , <br />Signa re of Corporate facer, Owner, or Designee <br />~a-~-off <br />Date <br />