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• III IIIIII!IIIIIIIII .r-~• tF~ <br />ANNUAL REPORT ~R 1 ~ ZOQ~ <br />DivisiontlfMltlBf8b~0e°""'/ <br />PERMITTEE NAME: Mountain Gravel & Construction Co., Inc. _ <br />PERMIT NO.: M-1983-028 ~~ <br />OPERATION NAME: Wallace Pit ~ ~~ <br />ANNNERSARY DATE: February 24, 2000 '' <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 <br />COUNTY: Montezuma <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an operator shall <br />- `submit [he anriua~ fee, a report :uifimap snowing the extent of current-disturbances io affecled lana; --'--'- <br />reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note thnt an adequately Inbeled mup that clearly delineates and includes the above elements may <br />since for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name:/ G///{/„(1 ~ / /L4~Si >( f <br />ddress: ~0 ~ox 7~' <br />v Lo.~FJ' ~o ~/~~3 <br />Company: u u6L ~s{Ru~~l ~°"t <br />Phone No.: (97a ) ~~- - 7,,z~3.2 <br />FAX No.: (~70 ~ ~~~ -S'o,cS- <br />If there aze additional comments and/or information that should be provided to the Division, please <br />provide it on a sepazate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signature of Corporate Officer, or Owner Date <br />UP l~~s <br />INSTRUCTIONS ON BACK <br />M:~PER M n1MASTERDOC UM EMI'SVd-AF-01 <br />