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IIIIIIIIIIIII <br /> ANNUAL FEE and REPORT REQUEST <br /> RECEIVED <br /> PERMITTEE NAME: Baca County MAR 0 9 2001 <br /> PERMIT NO.: M-1993-088 <br /> OPERATION NAME: Gunkel Pit No 31 Division of Minerals and GeaI091 <br /> ANNIVERSARY DATE: March 7,2001 <br /> ANNUAL FEE DUE: $281.00(Due on or before your anniversary date) <br /> COUNTY: Baca <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 wi!! "- nerformed during the coming year, the dates for the <br /> b; -inning of active operations,:and the date active operatiops ceased for the year. if any. <br /> Please attach your revised written annual report and it m--7A -cport map to this form. Please rote th,11 an <br /> adequately labeled reap that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following pennittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Ray Miller <br /> Pemiittee Name: Baca County <br /> Address: 741 Main St. <br /> Springfield, CO 81073 <br /> Phone Number: (719) 523-6532 <br /> Fax Number: (719) 523-6584 <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 <br /> enclosed. <br /> Signature of Corporate Officer or Owner <br /> 3- 8- a ( <br /> Date <br /> M.\PEP,Mn)MASTEP,DOCUMENTSW-AF-04 <br />