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.r , <br /> <br />RECEIVED <br />APR 0 1 2003 <br />PERMITTEE NAME: <br />PERMIT NO,: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Crowley County <br />M-1982-126 <br />Crowley Cnty Grav 2 <br />Apri128, 2003 <br />Oivisien of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Crowley <br />According-to=C:R~S: 34=32e5=1=16 or C:R:S-34=32-1~16-each year,-on`the anniversary" date of the permit, an <br />` operator shall submit the a`nnual~fee,-a ieport and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated 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 yron• revised written annual rennrt and annnal re nrt m p to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />!~I 'K~ ,¢~o~f er <br />Permittee Contact: ~ ^° a°--~° ' <br />Permittee Name: Crowley County <br />Address: 603 Main St. Ste. 2 <br />Ordway, CO 81063 q ' I c / , / t <br />Phone Number: "' °`~-.rm~~v',-~i-io - _ _ - ~ ~~ / a ~ 7 T T 7 ~t' e~-~ ~~ <br />Fax Number: (719) 267-3114 <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 <br />A <br />w <br />TF . ALCM„-I~RJ~i t- <br />Signature of Corporate Officer, Owner, or <br />Date <br />M:IPERMINNAS7ERD000MEN7SIM-AF-94 <br />