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999 <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMIT-FEE NAME: Neil's Excavating RECEIVED <br /> PERMIT NO.: M-1980-143 OCT 2 9 2001 <br /> OPERATION NAME: Texas Creek Grav Pit <br /> ANNNERSARY DATE: October 27,2001 Division of Minerals and Geology <br /> ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br /> COUNTY: La Plata <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 operator <br /> shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br /> reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br /> during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br /> of active operations, and the date active operations ceased for the year, if any. <br /> Please attach yotrr revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Bruce E. Neil <br /> Permittee Name: Neil's Excavating <br /> Address: 486 CR 515 <br /> Ignacio,CO 81 137 <br /> Phone Number: (970) 884-2290 <br /> Fax Number: (970) 884-2290 <9�0100 / <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 enclosed. <br /> 4-1 <br /> Signature of Corporate Officer or Owner <br /> !O 2S e/ <br /> Date <br /> AIAPERM ITW ASTERDO(t1 MENTSNI-AF 01 <br />