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f <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Larimer County <br />M-1977-425 <br />Strang Gravel Pit <br />Apri123, 2002 <br />RECEIVE p <br />MAR ? 2 2002 <br />)ivision of Minerals and GeofogY <br />$688.00 (Due on or before your anniversary date) <br />Larimer <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 />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation-accomplished.to:date and,during-the. preceding-year,-new distutfiancerthat are anticipated"to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for [he <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual resort and annual report maa to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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: Dennis C. Morrison <br />Permittee Name: <br />Address: <br />Lazimer County <br />P.O. Box 1190 <br />Fort Collins, CO 80522 <br />Phone Number: (970) 498-5652 <br />_T FazNumlieir ' --- (970) 221=0232- ""'- -°°---_ - --'-- - - -- - -- _ _ .. y_ <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 <br />enclosed. <br />Signature of Corporate Officer or Owner <br />Date <br />M:~PERMTMASTERD000MENTSN1-AF-01 <br />