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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />T M Russell & R C Barger <br />M-1980-037-HR <br />Ingleside Quarry <br />October 1, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Lorimer <br />RECE>yED <br />OCT 0 7 ZQd2 <br />Division of Minerals and Geolu9Y <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 />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that wilt 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 vour revised written annual resort and annual report map to this form. Please note that an <br />adequately labeled map tlu~t clearly delineates and includes t)te 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; Delores Barger <br />Permittee Name: T M Russell & R C Barger <br />Address: 11585 N. Hwy 287 <br />LaPorte, CO 80535 <br />_ Phone Number: (970) 493-7323 <br />Fax Number: _ -- -- - - -- <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 />~~dnr~62 s~D G'4~2~*ny~ ,ANC , <br />Signg~,er of C9f~orate Office ycrfer, or Designee <br />v ~~/~~ / ~ <br />Date ~c~ <br />~i9,~ s~~-~ldd <br />M:~PERMI'M~ ASTERDOCUM ENTSN4-AF-01 <br />