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• � � IIIIIIIIIIIIIIIIIII <br /> ANNUAL FEE and REPORT REQUEST <br /> RECEIVED <br /> PERMITTEE NAME: Las Animas County <br /> PERMIT NO.: M-1998-011 APR 0 6 2001 <br /> OPERATION NAME: Unwin Gravel Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: April 1,2001 <br /> ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br /> COUNTY: Las Animas <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 <br /> operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br /> beginning 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 mote that an <br /> adequately labeled snap that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: /� <br /> Permittee Contact: ucero Pd 9L 0d Q C-7 fV 4/v / / <br /> Penn ittee Name: Las Animas County �'4:j �/I/i �}S �J/I/'�y <br /> Address: 2200E FiFSFSt., RM 1(14 M61 M <br /> Trinidad, CO 81082 001' r)j n / 'o -(16 � <br /> Phone Number: (Z19}846.4486- 7/ 2 p 7 6 —( /y 6 2 <br /> Fax Number: 7/ 9— 10 Q <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 <br /> enclosed. <br /> Signature of Corporate afficer or Owner <br /> 3/.�? �/ ./ <br /> Date <br /> M:T E RM I TMA S TE R DOC UME NT SW.AF-04 <br />