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~~ T <br />. ~ <br />ANNI7AL ~E and REPORT REQUEST ~~ <br />PERMITTEE NAME: l Donald R Hart Abp ~~~~~ <br />PERMIT NO.: ~M-1980-049 O~~~stc•~ O~? <br />`'~o! °' ~ ~~I <br />OPERATION NAME: Mott Gravel Pit ''9ana~fe~~oh <br />ANNIVERSARY DATE: February 18, 2007 ~ <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <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 />--- daring the upcoming year,-rectamatiori that-witl°be perfcrnred during the coming year; the-date~ for the beginning - <br />ofactive operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous vear and no new chances to <br />the previous year's map are necessary. then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Donald R. Hart <br />Permittee Name: Donald R Hart <br />Address: 3500 Clear Fork Rd. <br />- " -"Crawfoid,~CO-Shtl -- --- -- -- -- <br />Phone Number: (970) 921-5299 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />be or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~ re o orate face ,Owner, or Designee <br />~~„~ ~2 ~~ 0~,7 <br />Date <br />