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Q~ W <br />RECEIVED <br />ANNTiAT. FF,F. and REPORT RF.OTTFST JAN 0 9 2006 <br />Division of Minerals and Geologp <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE; <br />COUNTY: <br />Las Animas County <br />M-1997-100 <br />Branson Gravel Pit <br />January 16, 2006 <br />$281.00 (Due on or before your anniversary date) <br />Las Animas <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 />--- -operato* 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 yeaz, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written annnal r~nrt and annnal reply'[ marn to this form- 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: Phil Dorenkamp <br />Permittee Name: Las Animas County <br />Address: 2000 N. Linden Ave. <br />Trinidad, CO 81082 <br />.Phone Number: (719) 846-2931 <br />Fax Number: (719) 846-0434 <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 />M:~PERMIT4MASTERD000MENTSVvI-AF-04 <br />