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bm k. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME; <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />I~ANLVi1Ai. FF.F, and RF.PnRT RF.(~iTFRT <br />~~Gillette Sand and Gravel, Inc. <br />~M-1992-009 <br />Gillette Pit <br />February 9, 2006 <br />RECEIVED <br />°'" FEB 0 8 2006 <br />Division ~1 Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Teller <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-st.-lmrit-tho-annua]-fe:,--a report and map-shocvirs the cwtcnt of current-uistr~ban.,o5-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 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' our revised written annual rpnnrt and annnal rennM main 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: V. C. Pyles <br />Permittee Name: Gillette Sand and Gravel, loc. <br />Address; 20575 Highway 24 <br />Woodland Park, CO 80863 <br />Phone Number: (719) 687-3111 <br />-.~~---- <br />Fax Number: <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 />Corporate Officer, Owner, or Designee <br /> <br />Date <br />