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" ~ III IIIIIIIIIIIIII ~ <br />II <br />999 <br />r* Aty, <br />Ate, <br />PERMITTEE NAME: Yuma County ~ ~ 4t~ ," ~ ~ , <br />PERMIT NO.: M-S1-256 <br />OPERATION NAME: Ekberg Pit* <br />ANNNERSARY DATE: June 30, 1999 _r •E!~/(_® <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Yuma ~~~ ~ 1 9999 <br />\ ,.... ..:,:nerab 8 GC0109Y <br />According to C.R.S. 34-32-116(3)(x), each r, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report, n ap showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note that nn adequately labeled map tha! clearly delineates and <br />includes the above elements Wray sn~ce for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: ~ Jl,'~~ia.~G/ 6•.ci., Company: lli~.-,. a l~ ,,,[may <br />Address: /3 ~o s~.~[ d/4.~-~ .IF Phone No.: ('970) 33a - s7/Ir <br />f% (~/ ~'a~s ~ Fax No.: ( 97d ) .3aa-.~s'a9 <br />(E there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />