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ANNUAL FEE and REPORT REOUEST RECEIVED <br /> PERMITTEE NAME: Gypsum Ranch,LLC NOV 0 2 2001 <br /> PERMIT NO.: M-1998-014 Division of Minerals and Geology <br /> OPERATION NAME: Gypsum Ranch Sand and Gravel Pit <br /> ANNIVERSARY DATE: November 3, 2001 <br /> ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br /> COUNTY: Eagle <br /> According to C.R.S. 34-32.5-1 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br /> shall submit the annual fee, a report and map showing_the_extent of current disturbances 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 /> 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 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: John C. Martin <br /> Permittee Name: Gypsum Ranch, LLC <br /> Address: 14156 Hwy. 82 <br /> Carbondale,CO 81623 <br /> Phone Number: (970) 945-1203 <br /> Fax Number: (970) 963-1311 <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 /> GAS( ' <br /> S gnature of Corporate Officer or Owner <br /> /4�30 �/ <br /> -- 1 <br /> Date <br /> M TERNIMMASTERDOCUMENTSW AF-01 <br />