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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Nienhueser Construction & Excavating Co <br />M-2001-018 <br />Schumacher II <br />April 19, 2002 <br /> <br />RECEI!/ED <br />MAR 2 7 2002 <br />Division of Minerals and Qeology <br />$281.00 (Due on or before your anniversary date) <br />Logan <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 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 yeaz, reclamation that will be performed during the coming year, the dates for [he 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 for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact. Keith Nienhueser - <br />Permittee Name: Nienhueser Construction & Excavating Co <br />Address: <br />P.O. Box 173 <br />Phone Number: <br />1500 10th Ave. <br />Sidney, NE 69162 <br />(308)254-3453 <br />Fax Number: ` (303) 254_3455 _ _ _ _ _ __ _ <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 aze enclosed. <br />Signature of Corporate Officer or Owner <br />O3~ as~ 0~-- <br />Date <br />M:~PERMITMASTERDOCUMENTSUv1-AF-01 <br />•''. <br />