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RECEEVE© <br />APR 1.9 2004 <br />Divisign of Minerals & Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Las Animas County <br />M-1998-011 <br />Unwin Gravel Pit <br />'~l~J <br />RED <br />a, <br />~' ~ , ~ ~ r' <br />DNISibR et 19ihiein~+w aa0lYpq <br />April 1, 2004 <br />$281.00 (Due on or before your anniversary date) ~~' 000 ~~ <br />Las Animas <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 />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 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 annual rennrt and anmtal rePnrf marn 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: Phil Dorenkamp <br />Permittee Name: Las Animas County <br />Address: 2000 N. Linden Ave. <br />Trinidad, CO 81082 <br />Phone Number: <br />Fax Number: <br />If you have <br />below or a <br />(719) 846-4766 <br />(719)846-0434 <br />dal comments and/or information that should be provided to the Division, please provide it <br />~ it,4o this form along with your written report and map. Annual Report instructions are <br />or Designee <br />M:SPERMI"11MASTERD000bfEMS~M-AF-04 ~(~ <br />