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S `~ <br />~~o ~r <br />ANNTiAT. FF.F, and RF.PnRT RF.nTTFST <br />RECEAVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Crites Sand and Gravel <br />M-1999-022 <br />Crites Sand and Gravel <br />July 19, 2004 <br />$281.00 (Due on or before your anniversary date) <br />Saguache <br />JUL 2 2 2004 <br />Division of Minerals & CeologY <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-submit-*.he-an*~ual-f e,,-a- report-ard-map showing the-extent of c~»rren±-disturbances-to-a€€ected-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 your revised written annual rennrt and annual rennrt manrtn 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: Dave Crites <br />Permittee Name: Crites Sand and Gravel <br />Address: 11044 W. Hwy. 112 <br />Del Norte, CO 81132 <br />Phone Number: (719) 657-2338 <br />Fax Number: (719) 657-2404 <br />i~ <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 />igna of Corporate fficer, Owner, or Designee <br />~C~ ~~~ <br />Date <br />