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•~ - -a <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />ANNUAL FEE and REPORT REQUEST <br />Neil's Excavating <br />M-1980-143 <br />Texas Creek Grav Pit <br />RECEIVED <br />ocr z s 2~z <br />October 27, 2002 Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />La Plata <br />According [o 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 the annual fee, a report and map showing_[he- extent_of_current_disturbances-to-affected-land--- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during [he 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 vour revised written annual report and annual resort map 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: Bruce E. Neil <br />Permittee Name: Neil's Excavating <br />Address: 486 CR S l5 <br />Ignacio, CO 81137 <br />Phone Number: (970) 884-3.090 8 $ ~ ' Z ~'4 ° ~~,~,,.~ $ ~~{ ~ 29 0 <br />-- Fax-Number-(970)884-298-/ott2__~~-------.~wSE----- ~S~'f----1-UV~ - - -- <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 />V.1yLa-- ~ i~ <br />Signatures e of Corporate Officer, Owner, or Designee <br />lo~ z S~o'2- <br />D tae <br />M iPERMI"I~MASTERDOCUMENTSNI-AF-01 <br />