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<br />PERMiTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Bear River Sand & Gravel <br />M-1986-040 <br />Bear River S & G <br />November 20, 2002 <br />` U- <br />RECE9!!ED <br />NOV 19 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Routt <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 operator <br />shall submit [1~@_anmtal~eP-_a rPpntLand._map_showing~he-exten~of-errant-disturbances-to-affected ]and,-- ---- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual resort and annual report mau to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Lester Crawford <br />Permittee Name: Bear River Sand & Gravel <br />Address: P.O. Box 616 <br />Oak Creek, CO 80467 <br />Phone Number. (970) 736-23]0 <br />Fax Number: <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 enclosed. <br />S nature of Corporate Officer, O er, or Designee <br />/-l~Oz <br />Date <br />M: W ERMnN7 ASTERDOCUMENTSVvI-AF-01 <br />