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oEC 'L 10 <br />of n, <br />'Woo ? ?1n9 a? /7` ??' i <br />ANNUAL ? Mun REPORT RE VEST <br />0 <br />PERMITTEE NAME: Morgan Sand & Gravel Inc <br />PERMIT NO.: /M-1977-094 <br />OPERATION NAME: Westhoff Pit <br />ANNIVERSARY DATE: December 20, 2008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Morgan <br />0A <br />rr?i 1 \! L..D <br />?? ? 22008 <br />t ?t?r?mation. <br />®Ni???afl Q aid ?,atety <br />N1oif%q <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 accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />- - -- the upcoming year, rec-lama&Sn- -t Tat will ape- ormed?c uririg-the coming year_t 6 atd es for ith`ebegiririing <br />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. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's man are necessarv, then no new man is reauired, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Greg Westhoff <br />Permittee Name: Morgan Sand & Gravel Inc <br />Address: 21215 Hwy No 52 <br />P.O. Box 1443 <br />Fort Morgan, CO 80701 <br />Phone Number: (970) 867-8074 <br />Fax Number: (970) 867-3774 <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 />'Pe""N ). ?? <br />SSignaturdQf Corporate Offic r, wner, or Designee <br />Date