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t <br />/'- <br />PERMITTEE NAME W <br />i <br />C RECEIVED <br />: ash <br />ngton <br />ounty <br />PERMIT NO.: M-1988-032 MAY 0 2 2003 <br />OPERATION NAME: Fassler Gravel Pit <br />als and Geology <br /> pivision ~i Miner <br />ANNNERSARY DATE: May 18, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Washington <br />According to C.R.S. 34-325_1.16 or_C,R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />- -operator shall-submit"the annual"fee, a report and map showing the extent of current dtsfurb`arices 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 ym~r revised written annnal report and annnal re nrn f man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following pet7ttittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Tim Davis <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Washington County <br />150 Ash St. <br />Akron, CO 80720 <br />(970)345-2701 <br />(970)345-2702 <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 />~~~ <br />Signature of orporate Officer, Owner, or Designee <br />\ ~,S~~o3 <br />Date <br />\\ <br />M:~PERMITV.IASTERD000M ENTSVvi=AF~\ <br />