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~~~`' <br />,/auc 7 0 Zoos <br />PERMITTEE NAME: 1/ Kit Carson Couuty ~ivision of Reclamation, <br />PERMIT NO.: /M-1982-054 Mining and Safety <br />OPERATION NAME: Eberhart Pit ~ <br />ANNNERSARY DATE: June 24, 2006 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Kit Carson <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation-accomplished.to.date-and-during the-preceding year, new disturbances that-are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ym~r revised written annual re~nrt and annual r~nrf m ~ to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />ANNTiAT,FFF,andRF,P(1RTRF.OTTFST RECEIVED <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: <br />Lyn Brownfield <br />Pennittee Name: <br />Address: <br />Kit Carson County <br />P.O. Box 160 <br />Burlington, CO 80807 <br />Phone Number: (719) 346-8139 <br />Fax Number: (719) 346-7242 <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 form along with your written report and map. Annual Report instructions are <br />Signature <br />Date <br />Owner, or Designee <br />M:~PERMITN7ASTERDOCUMEM5IM-AF-04 <br />