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~ iii iiiiiiiuiiiiii .~ <br />F •1 <br />ANNUAL REPORT ~ ~$ ~~_ <br />.i y~ <br /> <br />PERMITTEE NAME: John Terry & Ward Nichols <br />PERMIT NO.: M-81-013 , _ ....t~~~ <br />OPERATION NAME: Nichols Gravel Pit <br />ANNIVERSARY DATE: October 21, 1999 ~~ 1 15 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 7jV,...~~~~rMrng~S~G <br />COUNTY: Mesa <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing [he extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances [hat are anticipated [o occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note that nn ndeyuntely lnbe[ed nrnp that clearly delineates and <br />hrcltrdes the above elements may suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: ,Jol}~f ~lLf{0~5 <br />Address: S[b00 eG i2oq~ <br />1~ O- Pjo~C 2BS <br />~q- C-o X140 `{3 <br />Company: IViC-~b~ C~KA-cl~C. ~-~ <br />Phone No.: (~O ) Zb~ - SSZJ <br />Fax No.: (9'70 ) ZloB - S'732 <br />>f [here aze additional comments and/or information that should be provided [o the Division, <br />please provide it on a sepazate sheet and attach it to this report form along with your map and/or <br />written report. <br />D- lZ -q <br />Si lure of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />