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~~ p l~, <br /> <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Elam Construction, Inc. <br />M-1991-079 <br />Mule Farm Gravel Pit <br />February 18, 2004 <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />FEB l 9 2004 <br />Division of Minerals & Geology <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 />f tf t r~., .,1 rP., rrnnrt and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding yeaz, new distur--'bances 71at-are~irtieipated-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 your revised written anneal renorf and anneal re~t~ 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; Harold F. Elam <br />Permittee Name: Elam Construction, Inc. <br />Address: 1225 S. 7th St. <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-5370 <br />Fax Number: (970) 245-7716 <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 enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />Harold F. Elam, President <br />/ 7 Feb .Z-a~5' <br />Date <br />M:~PERMI]1MASTERDOCUMENTSUI-AF-01 <br />