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s III IIIIIIIIIIIIIIII ~ ~~~~~J~oo <br />sss ~pN 1~ ~~GQOwp,Y <br />ANNUAL REPORT <br />o~~a~s <br />O~'~~~~ <br />PERMTI'TEE NAME: Fremont County <br />PERMfI' NO.: M-1989-084 ~~ <br />~ "" <br />OPERATION NAME: Oak Creek Gravel Pit ' :'` <br />s~ ~ y .~ <br />ANNNERSARY DATE: January 20, 2000 ~ ~ <br />ANNUf~L FEE DUE ON ANNNERSARY DATE: $225.00 <br />COUNTY: Fremont <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming yeaz, reclamation that will be <br />performed during the coming yeaz, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual resort. <br />Please note that nn adegtsnte[y labeled mup that clearly de[irrentes and inchcdes the above <br />elemenhr may suffice for a written report. <br />Please [}ape or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: ~N ~tCtt.p Company: ~v'¢cTIL ~~h~[_ <br />Address: ~ogcrti. '3'~ g Phone No.: (~ °~ )°~rZ 4a~$ <br />Ck?toFKw . ~ ~~'2,2} FAX No.: (~~) °Ja1Z M'k1'r3 <br />If there aze additional comments and/or information [hat should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />~..~ S {~s,...~ 9at- o. ~~ \\ ~ Imo <br />Signature of Corporate Officer, or caner Date <br />INSTRUCTIONS ON BACK <br />M:~PER MITMAST ER DOCUMENTSUI-AF-PI <br />