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<br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Huerfano Couuty <br />PERMIT NO.: M-2001-106 RECEIVED <br />OPERATION NAME: Orlando Pit DEC 0 4 2006 <br />ANNNERSARY DATE: December 18, 2006 pw~ion of ReWametlop. <br /> Miring end SatelY <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />COUNTY: Huerfano <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-shaH-sabmit the-annnal-fee~ a-report-arrd-rmap-sirowing-th~ c-sctent-of-currettt di~turttan~s 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 man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, resort, and <br />associated map. If no new disturbances or reclamation have occurred during the previous vear 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bill Brunelli <br />Permittee Name: Huerfano County <br />Address: 401 Main St., Ste. 105 <br />Walsenburg, CO 81089 <br />Phone Number: (719) 738-2420 <br />Fax Number: (719) 738-3996 <br />If you have additional comments andfor information that should be provided to the Division, please provide it <br />below or attach i to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signatur .of Corporate fficer, Owner, or Designee <br />~l ,~5 "~lo <br />Date <br />M:IPERMITMASTERDOCUfvD;M51M-AF-04 <br />