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..-. <br />ar <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: ' <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNIiAL FFF, and REPORT RF.niiF.ST <br />River Bottom Land Corporation <br />M-1992-100 <br />River Bottom Land Gravel <br />February 5,2003 <br />$281.00 (Due on or before your anniversary date) <br />Delta <br />~iECEIVE® <br />JAN Z 3 2003 <br />Givision of Minerals and Geology <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 />- shall-submit-the annual fee,-a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that ate 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 ylyrr revised written anneal rennrt and anmral rennrt m ~n to this form. please note that an <br />adequately labeled map that clearly delineates and includes the 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: Patricia Farnsworth <br />Permittee Name: River Bottom Land Corporation <br />Address: 1494 Hwy. 133 <br />Paonia, CO 81428 <br />~_ .,~Phone.Number:_ __ (970) 527-4434. _. _ <br />Fax Number: (970) 527-5522 <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 of Corporate ficer, Owner, or Designee lJ <br />- r 7-v3 <br />Date <br />M:~PERMITNIASTERDOCUMENTSU~I-AF-01 <br />