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iii iiiiiiiiiiiu iii <br />• <br />:i=i~~i ~ ci_, <br />ANNUAL REPORT <br />PERMITTEE NAME: Weld County <br />PERMIT NO.: M-1987-186 <br />OPERATION NAME: Peters Pit No 2 <br />ANNNERSARY DATE: March 1, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Weld <br /> <br />~ra~O1 <br />According to C.R.S. 34-32-116(3)(a), 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 <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances [hat are anticipated [o occur during [he upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for [he year, if any. <br />Please attach your revised annual report map and written report to this annual report. <br />Please Hole tlmt nn adequately labeler! mnp thnt ciearly delineates and includes the ahove <br />elements may since for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name:~^/(/~~s,~ Company:Wi"J~ ~pW'Fv p(~v- /`ir~s <br />i <br />Address: P ~ Tr ] 5 s Phone No.: (9 JD ) 35ti- yarn v ~ X50 <br />FAX No.: (~ 7v ) 3oH -G 51 9 z <br /> <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to [his report form along with your map and/or <br />written report. <br />~ a/a.l~o <br />tgnature of orporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />M:WGRMRVdASTERD000MENTSU1~AF-M <br />