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why <br />L <br />PERMITTEE NAME: <br />PERMff NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~~~il1ED <br />sf~fo~ <br />Date <br />r/NNiiAT. FF.F, and RF.PnRT RF.nTJF.ST <br />~ /Montezuma County <br />~/' M-1985-031 <br />Mancos Gravel Pit <br />May 31, 2006 <br />MAY 2 21006 <br />vGiuision of Minerals end Geology <br />$688.00 (Due on or before your anniversary date) <br />Montezuma <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 />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 your revised written annnal re,Rprt and annnal report maw to this form- please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sr~ce for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Lloyd Everett <br />Permittee Name: Montezuma County <br />Address: 1680 Hwy. 145 <br />Phone Number: <br />Fax Number: <br />~Ua ~~-~~ <br />o ~~ ~~ <br />S' slur f orporate Officer, Owner, or Designee <br />Cortez, CO 81321 <br />(970)565=8666 <br />(970)565-8252 <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 />enclosed <br />M:~PERMITN1ASTERD000MENTSM-AF-04 <br />