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~; ~ ~ 1 <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Stone Cliff Investments, LLC <br />/1~I-2003-002 <br />Ghost River Gravel Pit <br />August 11, 2007 <br />RECEwuED <br />-BUG 0 7 2007 <br />Division of Reclamation, <br />/Nfining and Safety <br />$323.00 (Due on or before your anniversary date) <br />Iluerfano <br /> <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operator <br />--shall-submit-the--annual-fee,_a-reporx_and-map-showing-the_extent_of~ucrenti_disturbances_to affected land, - <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming yeaz, 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 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 durinti the previous year and no new chanties to <br />the previous year's map are necessary, then no new map 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 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: Steve Melvick <br />Permittee Name: Stone Cliff Investments, LLC <br />Address: ~~n rra;e~+~^ nt<., <br /> <br />Phone Number: <br />Fax Number: <br />(719)686-9080 <br />(719)686-9081 <br />~.~5 E ~sT~ <br />~VOA~ilrivd ~'~ . C'0 <br />~ 63 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Officer, Owner, or Designee <br />Date <br />