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<br />. iii iiiiiiiiiiiii iii <br />999 <br />~. <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Delta County <br />PERMIT NO.: M-1979-140 <br />OPERATION NAME: Lemoine Gravel Pit <br />ANNIVERSARY DATE: February 16, 2002 <br />RECEIVED <br />JAN 2 8 2002 <br />Division of Minerals and Geology <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Delta <br />~~ <br />According [o C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on [he anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing [he extent of current disturbances to affected <br />I:uul. reclamation aecouy~li~hed lu date and Burins th< prrceding Fear. new dismrbances that are ^nticiputeil w <br />occur during the upcoming year, reclamation that [sill be perfrnmed Burin ~ the coming year, the dates for tho <br />be,inning of active operations, and the date active operations ceased for the year, if anv. <br />Plracc atloch your rc~ iscrl ~~ ritfcn annnnl rcpnrl and :utnunl tenor[ mnn fn This form. Plrn cr nnrr rl«rl n.. <br />udcgl«urlc lubrled nmp that rlrurh' drlinrurc~ and urchrdcs !hc abort clcnlrnr~ nlur eufflC'(' Jura Ilrulcn <br />repurl. <br />Division records indicate the following permittee contact information. Plra,e ~zrif_1' and make an_v necessary <br />changes: <br />Permittee Contact. Lalry Record <br />Permittee Name: Delta County <br />Address: 501 Palmer St., Ste. 227 <br />Delta, CO 81416 <br />Phone Number: <br />(970)874-2100 <br />Fax Number: (970) 874-21 14 <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 />igna[ur of Corporal Officer or Owner <br />/-oZa - o z., <br />Date <br />M 6'ERA11TN1~STERD000MENTSN7~AF t}I <br />