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'~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />„~ <br />McAtee Construction Co. <br />M-1976-056 <br />Riverside Pit <br />February 22,2005 <br />$688.00 (Due on or before your anniversary date) <br />Logan <br />RECEIVE® <br />FEB 2 22005 <br />Division of Minerals end Geology <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 the annual fee, a report and map showing the extent of current disturbances to affected land, <br />'-'reclamation~ccomplished-to-date-and=during-the precedir>~yeaz,_netv_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 re~rt and annual re~nrt man to 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: Tim Gossman <br />Permittee Name: McAtee Construction Co. <br />Address: P.O. Box 1908 <br />Phone Number: <br />"- FaxNumber: <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 />~~~~_~ ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />Sterling, CO 80751 <br />(970)521-0651 <br />Date <br />