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� Ck# `� \��� IIIIIIIIIIIIIIIIIII <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Grand Junction Pipe& Supply Co. <br /> PERMIT NO.: M-1978-357 RECEIVED <br /> OPERATION NAME: Bradbury Pit <br /> ANNIVERSARY DATE: January 25,2001 JAN 1 y 2001 <br /> ANNUAL FEE DUE: $688.00 (Due on or before your anniversary datepivition of Minerals and Geology <br /> COUNTY: Mesa <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 your revised written annual report and annual report map to this form. Please note that art <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: Edward J. Settle <br /> Pennittee Name: Grand Junction Pipe& Supply Co. <br /> Address: P.O. Box 1849 <br /> Grand Junction, CO 91502 <br /> Phone Number (970) 243-4604 <br /> Fax Number: (970) 243-6703 <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 /> I <br /> Signature oPtorporate Officer or Owner <br /> /_ -7z _ © � <br /> Date <br /> M:W ERM IT\MASTERDOCU MENTSN-AF-01 <br />