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J <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Western Gravel, Inc. <br />M-1996-008 <br />North R-34 Pit <br />Apri14, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Montrose <br />RECEIVED <br />APR l y 2003 <br />Division o/Minerals and Geology <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 accomplished to date and during the preceding_year, new disturbances that are anticipated So 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 annual rennrf and annual rennrt m ~n 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 information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Judy DeVincentis <br />Permittee Name: Western Gravel, Inc. <br />Address: 3001 N. Townsend Ave. <br /> Montrose, CO 81401 <br /> <br />Phone Number: .. ~~ <br />(970) 249-2431 <br />Faz Number: (970) 249-0590 <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 />/ ~,, <br />Si e ofslprporate O ~cer, Owner, or Designee <br />(//~~ _o ~ <br />Date <br />M:IPERMITV.IASTER DOCUM ENTSVN-AF-01 <br />