2000-12-18_REPORT - M1984108 (2)

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:k47t6Al 181 '00 999 ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: Western Gravel, Inc. RECEIVE PERMIT NO.: M-1984-108 DEC 18 20CJ OPERATION NAME: Olathe Pit Division of Minerals and .,; ANNIVERSARY DATE: December 14,2000 ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) COUNTY: Montrose According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary da of the permit, an operator shall submit the annual fee, a report and map showing the extent of current diStL rbances to affected land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the date active operations ceased for the year, if any. Please attach your revised written annual report and annual report map to this form. Please note that an adequately labeled map that clearly delineates and includes the above elements may s Jfice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Joseph DeVincentis Permittee Name: Western Gravel, Inc. Address: 3001 N. Townsend Ave. Montrose, CO 81401 Phone Number: (970) 249-2431 Fax Number: rla - a 9— 059Z If you have additional comments and/or information that should be provided to the Divisio , please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. AZ ignatur Corporate Officer or Owner / Z -/ '/ -(L�'4 Date M TERMITMASTERDOCUMENTSM-AF-01