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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPJERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Crites Sand and Gravel <br />M-1999-022 <br />Crites Sand and Gravel <br />July 19,2003 <br />$281.00 (Due on or before your anniversary date) <br />Saguache <br />RECElVE[2 <br />AUG 2 8 2003 <br />Division ~f 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 the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamaation-accomplished-ta-date-and'duringthe~receditrg year; newzlisturliances'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 rennrt and annual rennrt 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: Dave Crites <br />Petmittee Name: Crites Sand and Gravel <br />Address: 11044 W. Hwy. 112 <br />Del Norte, CO 81132 <br />Phone Number: (719) 657-2338 <br />Fax Number: (719) 657-2404 <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 />~~c~ ~~ <br />Signatu~of C~or77porate Officer, Owner, or Designee <br />Date - L <br />M:~PERMITUTASTERD000MENTSVN-AFAI <br />