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999 <br /> ANNUAL FEE and REPORT REQUEST <br /> RECEIVED <br /> PERMITTEE NAME: Hardrock Sand and Gravel DEC 18 2000 <br /> PERMIT NO.: <br /> OPERATION NAME: Martin Pit 1-A Division of Minerals and Geology <br /> ANNIVERSARY DATE: December 18,2000 <br /> ANNUAL FEE DUE: $281.00(Due on or before your anniversary date) <br /> COUNTY: Moffat <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 <br /> - operator-shall submitthe-annual fee, a report and-map-showing the-extent-of current disturbances 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 your revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements mqv stffrce 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: Pat J. Weber ��/i d&I r 7P <br /> Permittee Name: Hardrock Sand and Gravel �/�is ►/c�R R <br /> -T -T <br /> Address: P.O. Box 141 <br /> Craig, CO 81626 <br /> Phone Number: (970) 824-APP4 <br /> Fax Number: ,S,411 e- <br /> lf 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 /> St nature or Corporate Officer or Owner <br /> Date <br /> M.TE R MI MIASTERDOC UMENTSN-AF-01 <br />