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ANNUAL FEE and REPORT REQUEST <br /> RECEIVED <br />PERMITTEE NAME: Lincoln County <br />PERMIT NO.: M-2000-066 AIL 0 ~ ~ <br />OPERATION NAME: Raymond Enderson Pit Division of Minerals and 6 <br /> eolugy <br />ANNIVERSARY DATE: July 12, 2002 <br />ANNUAL FEE DUE: $281.00 (Due on or before your an niversary date) <br />COUNTY: Lincoln <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~hall_submit_the.annuaLfee, a report_and_map_sh4wing 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 [he date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Don Blake <br />Permittee Name: Lincoln County <br />Address: P.O. Box 39 <br />Phone Number: <br />Fax Number: <br />Hugo, CO 80821 <br />(719)743-2337 <br />(719)743-2815 <br />If you have additional comments and/or information [ha[ should be provided [o 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 />6;~ ~L~ la 2 <br />Date <br />M iPERMINNASTERDOCUMEMSNI-AF-04 <br />