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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~ ~ /1/ / <br />ANNUAL FEE and REPORT REQUEST <br />/S//o. Way Co. <br />/M-1984-025 <br />Stage Stop Pit <br />July 26, 2007 <br />w' <br />RECEIVED <br />.~ !JUN 2 7 2007 <br />of Reclarnal~• <br />M'~9 and Safety <br />$$688.00 (Due on or before your anniversary date) <br />Saguache <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 operator <br />shall submit the annual fee, a report and map showing the extent of current 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 year, 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 your 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 durinc the previous year and no new chances 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: Rock L Southway <br />Permittee Name: <br />Address: <br />So. Way Co. <br />117 White Pine Dr. <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-5103 <br />Fax Number: (719) 589-5522 <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 enclosed. <br />Signature of Corporate ficer, Owner, or Designee <br />6 - a2 S O <br />Date <br />