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--~~ <br /> RECEIVED <br />PERMITTEE NAME: Kiowa County <br />PERMIT NO.: M-1483-112 AVM Q j 2UU3 <br />OPERATION NAME: Murdock Gravel Pit Division ~f Minerals and Geol <br /> ogy <br />ANNIVERSARY DATE: August 25, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Kiowa <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 />-- opera~r'sltall stilimif the annual-fee, a report and map showing the t:xfenf 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 that will 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 ynnr revised written annnat report and anm~al red nrt main 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: Richard McDaniel <br />Permittee Name: <br />Address: <br />Kiowa County <br />P.O. Box 100 <br />Eads, CO 81036 <br />Phone Number: (719) 438-5810 <br />Fax Number: (719) 438-5327 <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 forth along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />~. a~- 03 <br />Date <br />M:\PERMITMASTERDOCUMENTSU4-A F-04 <br />