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12/02/2004 17:54 9702475104 DMG DURANGO OFFICE PAGE 02/03 <br />- ~Q~:~ <br />~~FC o2 zoo~~ <br />Division of Minerals & Geology QCl 2 ~ Z40¢ <br />ANNYTAi. Ti ii',Ti. and RFPnRT RF.QiiF.ST Dryg/~po hgo F/¢td <br />PERA+ITI"l'EE NAME: Neil's Excavating h7~np~ls & G~Iegy <br />PERMIT NO.: ]V1-1980.143 <br />OPERATION NAME: Texas Creek Grav Pit <br />ANNfVERSARX DATE: October 27, 2004 <br />ANNUAL FF.fi DiJE: 5281.00 (Due on or before your anniversary date) <br />COUNTX: J,a Plata <br />According to C.RS. 34-32.5-116 or C.R.5. 34-32-116, each year, on the anniversary date of the permit, att operator <br />shall submit the~armual fee, a report .and rosy showing the extent of current disturbattecs 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 />Iof active operations, and the date active operations ceased for the year, if any. <br />Please attarh vnnrsevised_written anneal renortand nnnoal ~renert man to thin form. please not¢ that an <br />adequately Tabeled map that clearly delineates and includes the above elements may since 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 />Yermittee Name; Neil's }ixcavating <br />Address: 486 CR 515 <br />Ignacio, CO 81137 <br />Phone Number: (970) 884-i909 Z ~.9© <br />Fax Number: (970) 88490 1. o° n <br />$'`6if~zzg.a <br />7f you have additienal 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 />~~ <br />9i hue ofCbrpozate Officer, Owner, or Designee <br />ra ~ x-6/0 ~ <br />Date <br />