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,~ <br /> <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Larimer County <br />M-1977-425 <br />Strang Gravel Pit <br />Apri123, 2003 <br />APR 0 9 2003 <br />Uiidslen ~f Minerals and Ceolosy <br />$688.00 (Due on or before your anniversary date) <br />Larimer <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~ermit, a_n_ _ _ <br />- operator shall submit"the annual fee-a report 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 your revised written anneal report and annual refit main to this Fnrm. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since 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: Dennis C. Morrison <br />Permittee Name: Larimer County <br />Address: P.O. Box 1190 <br />Fort Collins, CO 80522 <br />---- -Phone.Number:~(9:70):498,S6S2~_-. __ _ <br />Fax Number: (970) 221-0232 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of C rporate OfFi r, Owner, or Designee <br />Date <br />M:~PERMI'M1ASTERD000MENTSUI-AF-04 <br />