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~,~/~~ REC~9.,r~ <br />MA" !' , <br />/ ANNiIAi. FF.F, and RF.PfiRT RF.OiiF.ST <br />/iYieion ~i Miom,.;,, ,;,,; Geology <br />PERMITTEE NAME: ~ Beavers Construction Co./High Mesa Gravel L.L.C. <br />PERMIT NO.: ~ M-2000-067 <br />OPERATION NAME: High Mesa Gravel Pit ~~C~/e <br />ANNNERSARY DATE: March 15, 2006 vM ~i'~ <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) AR 2 p ~jyy, <br />vB/yisl "wD <br />COUNTY: Delta °n °I M~yEfO/s °ndCej~rY <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 operatoP <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the_ rp eceding 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 xpnr revised written anneal rennet and annual report maP to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Art Beavers <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Beavers Construction Co./High Mesa Gravel L.L.C. <br />X33 c.-L.~~y_/ I I ~^-r-~I ~ ~J <br />P.O. Box 638 <br />Paonia, CO 81428 <br />(970)872-2323 <br />(970)872-2576 <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 />3 8- o ~ <br />Date <br />