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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Meeker Sand and Gravel, Inc <br />M-1976-038 <br />Meeker Pit <br />July 25, 2002 <br /> <br />RECEIVED <br />)UL 2 4.2002 <br />Division al Minerals and GealogY <br />$688.00 (Due on or before your anniversary date) <br />Rio Blanco <br />According to C.R.S. 34-32.5-1 i6 or C.R.S. 34-32-116, each year, on the anniversary date of the pemtit, an operator <br />---shall-submit-the-annual-fee; a-report- and-map- showing-the-extenE-of-current-disturbances-to-affected-]and,-- <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 vour 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: Joe P. Conrado <br />Permittee Name; Meeker Sand and Gravel, Inc <br />Address: P. O. Box 1550 <br />Phone Number: <br />Fax Number: <br />Meeker, CO 81641 <br />(970) 878-3671 <br />(970)878-5751 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />azure of Corporate Officer or Owner <br />~~/ O z. <br />Date <br />M:~PERMITVv1ASTERD000MENTSVN-AF-OI <br />