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<br />YYy <br />y ~.W, • / <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />v ANNiiAi, FF.F, and RF.PnRT RF,tNTF:ST <br />'~/Mesa County <br />M-1983-216 <br />Lumsden Canyon Pit <br />June 11, 2006 <br />$281.00 (Due on or before your anniversary date) <br />Mesa <br />REDEO~~ED <br />/ f~NN 0 5 2006 <br />f/ Division at Minerals andCeology <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 disturbances that are anticipated to _ <br />occur during the upcoming year, reclamation thafwill be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach fur revised written annual re,PnrM and anneal re~nrf 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 <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bud Thompson <br />Permittee Name: Mesa County <br />Address: 1000 S. 9th St. <br /> P.O. Box 20000-5025 <br /> Grand Junction, CO 81501-5025 <br />Phone Number: (470) 244-1811 - - - <br />Fax Number: (970) 256-1411 <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 thj'~, form along with your written report and map. Annual Report instructions are <br />enclosed. / i <br />Sign nnu'rAAe ,,of Cbrporate Offj6er, Owner, or Designee <br />~!~/1 ~ ~ r ~ ~~ <br />M:~PERM7TNrASTERDOCUMENTSUI-AF-04 <br />