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<br />~~ ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Currier Gravel Pit, Inc. <br />M-1980-203 <br />Currier Gravel Pit <br />June 29, 2004 <br />REGElVE® <br />JUN 0 9 2004 <br />DlVltian of Minerals & GealOp~ <br />$281.00 (Due on or before your anniversary date) <br />Mesa <br />According to C.R.S. 34-32.5-I 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 dishtrbances 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 v~nnr revised written annual re,Pnrt and anneal re,Pnrf main 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: Merial I. Currier <br />Permittee Name: Currier Gravel Pit, Inc. <br />Address: P.O. Box 27059 <br />Phone Number: <br />F.ax Number: <br />Denver, CO 80227 <br />(303) 734-2333 <br />(303)738-9557 <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 />Signature o Corporate Officer, Owner, or Designee <br />to - ~ °`1 <br />Date <br />