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,~' <br />~F ~ ~~~ <br />ANNUAL FEE and REPORT REQUEST <br /> RECEIVED <br />PERMITTEE NAME: Delta County / / <br />PERMIT NO.: M-1978-170 ,/ OCT 2 5 2001 <br /> <br />OPERATION NAME: Ellison Pit Division of Reclamation, I <br /> Mining and Safety <br />ANNIVERSARY DATE: October 26, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Delta <br />-- - According_to. C.R.S. 34-32.5-_116_or C.R.S. 34-32-116, each year, on_the_anpiversary 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 vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new chances to the previous year's map are necessary. then no new map is required. provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: Larry Record <br />Permittee Name: Delta County <br />Address: 501 Palmer St., Ste. 227 <br />Delta, CO 81416 <br />Phone Number: (970) 874-2100 <br />Fax Number: (9701874-2114 <br />e additional nts and/or information that should be provided to the Division, please provide it <br />attach it~o tl~i fo along with your written report and map. Annual Report instructions are <br />9igitdture bf'Corpornte t9fficer, Owner, or Designee <br />in 1~3~~ <br />Dat~ <br />M:WERMITMASTERD000MENTSUr-AF-04 <br />