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<br />ANNUAL FEE and REPORT REQUEST <br />R~CE~!/E'D " <br />NOV 2 1 2002 <br />Oivisien of Minerals and Geology <br />PERMITTEE NAME: Richard E. Curry Marilyn L. Curry dba Tri-County Gravel <br />PERMIT NO.: M-1977-205 <br />OPERATION NAME: Tri-County Gravel <br />ANNIVERSARY DATE: November 29, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Delta <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 the annual fee, a report and map showing_[he_ex[entsf_current_slisturhances~to~affected-land; <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 [he coming year, [he dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates mrd includes the above elements may since for a wruten report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Richard E. Curry J?h D oR 7~fi om 45 ~• G'tehr y <br />Permittee Name: Richard E. Curry Marilyn L. Curry dba Tri-County Gravel <br />T/tomcs F CuhhY <br />Address: P.O. Box 566 <br />Hotchkiss, CO 8]419 <br />Phone Number: (970) 872-3545 <br />Fax Number: (970) 872-3792 <br />If you have additional comments and/or information [hat should be provided to the Division, please provide it <br />below or attach it [o this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of rporate Officer, ner, or Designee <br />// ~S~oz <br />Date <br />M:IPERMIiiMASTERDOCUMENTStM-AF-O t <br />