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~~ <br />/1/ ANNiTAI. FFF, and RF.P(1RT RF.niTFST <br />PERMITTEE NAME: ~ Rio Blanco County RECEI3IED <br />PERMIT NO.: ~M-2000.073 '~ ~~N ~ s <br />OPERATION NAME: Shults Gravel Pit <br />plvlalon of Minerals and peolopy <br />ANNIVERSARY DATE: June 27, 2006 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <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 />operator shall submiYthe 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 ynnr revised written annual refit and annnal re~-nl't R18n 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: David Morlan <br />Permittee Name: Rio Blanco County <br />Address: 570 2nd St. <br />Phone Number: <br />Fax Number: <br />Meeker, CO 81641 <br />(970)878-9590 <br />(970) 878-3396 <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 />enclosed. <br />Si re of Corporate ~fi r, Owner, or Designee <br />. b/,/~ <br />Date <br />M:~PERMI7~MASTERDOCUMENTS~AI-AF-04 <br />