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CQ,O <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />.ANNUAL FEE DUE: <br />COUNTY: <br />/ANNTiAL FF.F, and RF,P(lRT RF.t7iiF.ST <br />Griffin Ranch LLC <br />i/ M-1989-084 <br />Oak Creek Gravel Pit <br />January 20, 2006 <br />r1~l.o~~ tl ~CJ <br />~ JAN 2 5 2005 <br />,; ~L <br />/fliViSion of Minerals and Csaafa(lY <br />$688.00 (Due on or before your anniversary date) <br />Fremont <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 />--~rperahr-shatl-suhmtt-the-armuat-fee-a report-and-map showing-the-entent-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 />J'lease attach ymir revised written anm~al rennet and anneal rennet m~ 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 />P'ermittee Contact: Adria Hooker <br />Permittee Name: Griffin Ranch LLC <br />Address: 420 Royal Gorge Blvd. Ste. 201 <br />Canon City, CO 81212 <br />- Phone Number:- <br />F.ax Number: <br />(~i~) ass- 5aa~ <br />If' you have additional comments and/or information that should be provided to the Division, please provide it <br />ba;low or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />_~ <br />Signature of Corporate Officer, Owner, or Designee <br />_ /~/9 ~a ~ <br />Date <br />(719) 275-5225 <br />M:U'ERMITNIASTERDOCUMENTSUI-AF-O4 <br />