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I ; °r: <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Rio Blanco County <br />M-1978-002 <br />Texas Creek Pit <br />February 23,2002 <br />RECEIVED <br />FEB 15 2002 <br />Division of Minerals and Geology <br />$281,00 (Due on or before your anniversary date) <br />Rio Blanco <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished Co date and"during the'prebedino ye5r; new disturbances-that-are~antiaipated to - <br />occur during the upcoming year, reclamation that will be performed during 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 vour revised written annual report and annual report map ro this form. Please note that mi <br />udeynatcly labeled map that clccrrlP delinea[e.r cued n~c(udes die above elements ma}' su/lice for « u~rirten <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact:. 3~erRst;~ele <br />Permittee Name: Rio Blanco County. <br />Address: 570 2hd St. <br />Meeker, CO 81641 <br />Phone Number: (970) 878-5601 <br />Fax Number: (970) 878-3396 <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 ins[mctions are <br />enclosed. <br />Signature of Corporate Offi er or Owner <br />Date <br />-t~-oZ <br />M:~PF:RM mM ASTF;RD000M ENTSVN-AF-fkt <br />