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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />J and M Schmahl <br />M-1984-001 <br />Surface Rock Pit <br />April 4, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />RECEIVED <br />MAR 2 12003 <br />~ieision of Minerals and Geology <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of [he permit, an operator <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach Ynnr revised written annual red nrt and anneal reRnrt m ~n to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John Schmahl <br />Permittee Name: J and M Schmahl <br />Address: 3842 G.7 Rd. <br />Palisade, CO 81526 <br />yi ~ 9~6g <br />Phone Number: (970) Z»fi <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />ignature of Corporate Officer, Owner, or Designee ~//t!'~ ~ <br />~! -f 2. _~~~ ~~S ~ / / c G/Alb A 7`/a ~J s T fee <br />Date y~l~ ~~ w / <br />~~ ~~~~C~ <br /> <br />M:~PEkM ITU1A$TEkDOCUMENTSU1-AF-01 <br />