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<br />PERMITTEE NAME: Montezuma County <br />PERMIT NO.: M-1999-077 <br />OPERATION NAME: Ormiston Gravel Pit <br />ANNIVERSARY DATE: October 25, 2003 <br />~EC~iv ~® <br />NOV Z p.ZC~3 <br />pivision at Minerals and Geolou'' <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Dolores <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-]16, 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 />hand, reclamation accomplished to date and dwing the preceding year, new dismrbances that are anticipated to <br />occur during the upcoming yeaz, reclamation that will be performed dwing 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 ynnr revised written anneal rennrt and annual reAnrt man to this form. please note thal an <br />adequately labeled mop thnt 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: Lloyd Everett <br />Permittee Name: Montezuma County <br />Address: 1680 Hwy 145 <br />Phone Number: <br />Fax Number: <br />Cortez, CO 81321 <br />(970)565-8666 <br />(970} 565-8252 <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 />gnatwe 8f Corporate Officer, Owner, or Designee <br />Dale <br />~-~- <br />M iPERM ITVNASTERDOCUMENTSVv1-AF-04 <br />