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i <br /> r : III IIIIIIIIII'IIIII <br /> sss <br /> ANNUAL FEE and REPORT REQUEST <br /> RECOvt ; <br /> PERMITTEE NAME: Glacier Gravel Products ,JUN I2 7 2001 <br /> PERMIT NO.: M-1985-001 <br /> Division of f�inerals and <br /> OPERATION NAME: J & J Pit <br /> ANNIVERSARY DATE: June 27,2001 <br /> ANNUAL FEE DUE: $ �00 (Due on or before your anniversary date) <br /> COUNTY: La Plata jig . to-c> <br /> According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary da a of the permit, an <br /> operator shall submit the annual fee, a report and map showing the extent of current dis rbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances t at are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming y ar, the dates for the <br /> beginning 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 snap that clearly delineates and includes the above elements may ufce for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Jim Helmericks <br /> PermitteeName: Glacier Gravel Products <br /> Address: 995 Hwy. 3 <br /> F <br /> Durango, CO 81301 <br /> Phone Number: (970) 259-3995 <br /> fir. &/z ;?>- ?— <br /> If you have additional comments and/or information that should be provided to the Divi$ion, 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 /> ,�t ��4 = C <br /> Signature of Corporate Officer or Owner <br /> 2 4 z�h <br /> Dates <br /> M.NERNIITLMASTERDOCUA4ENTSW.AFAI <br />