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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNP/ERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />C & J Gravel Products, Inc. <br />M-1980-146 <br />Montoya Pit <br />May 1, 2002 <br />RECEi1/ED <br />tdAY 0 1 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />La Plata <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 [he annual fee, a report and map show_.ing [he_-extent. of current-disturbances-to affected land, - <br />-- reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for [he beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map 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: John Gilleland <br />Permittee Name: C & J Gravel Products, Inc. <br />Address: 27661 U.S. Hwy. 160 E. <br />Durango, CO 81301 <br />Phone Number: <br />Fax Number: <br />(970)385-4112 <br />(970)385-5014 <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 Corpol to Officer or Owner <br />y-Zq•oZ <br />Date <br />M dPERMI7 VNASTERDOCUMENTSUI-AF-01 <br />