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:~ <br /> <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 />Pinneo Feedlot, LLC <br />M-1980-135 <br />Headley <br />October 7, 2006 <br />/!/lf~L <br />R~~.S~A~,t'~D <br />OCT 0 4 2006 <br />Division of Reclamation, <br />Mining and Safety <br />$688.00 (Due on or before your anniversary date) <br />Morgan <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 yeaz, 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 report and annual report man to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />maa. If no new disturbances or reclamation have occurred durinti the arevious year and no new chanties to <br />the arevious year's map are necessary, then no new mau is required, 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pemuttee Contact: Joel Chisum <br />Permittee Name: Pinneo Feedlot, LLC <br />Address: 32295 Hwy 34 <br />P.O. Box 384 <br />Brush, CO 80723 <br />Phone Number: (970) 842-0701 <br />Fax Number: _ _ _ _ _ <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 Corporate Officer, Owner, or De ignee <br />lO~.3~~ <br />Date <br />