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;i <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />.~ <br />PEAMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Colorado Gravel Products, Inc. <br />M-1999-117 <br />Colorado Gravel Products Inc, <br />June 23, 2002 <br />MAY 2 32002 <br />\~ <br />Oivisian of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Saguache <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operator <br />shah-submit tfie annnal~fee, a repori"and map showing the ezteni o cf uirent disturbances to affec[e~c land, <br />reclamation accomplished [o date and during the preceding year, new disturbances that aze 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 your 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 far a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Kenny Smith <br />Permittee Name: Colorado Gravel Products, Inc. <br />Address: 45247 Hwy 112 <br />Phone Number: <br />Fax Number: <br />Center, CO 8] 125 <br />(7]9)754-2738 <br />(719)754-2745 <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 />Signature ~ Corporate Officer or Owner <br />~ a70' ~Z <br />Date <br /> <br />M iPERMIT~MASTERDOCUMENTSN~I-AF-OI <br />