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~~ <br />A~ ~ RPZ <br />ANNUAL FEE and REPORT REpUEST <br />PERMITTEE NAME: Colorado Lien Company <br />PERMIT NO.: M-1985-038 <br />OPERATION NAME: Rifle Quarry 5'£~ 1 <br />ANNIVERSARY DATE: September 26, 2007 3 °~~ ~/ <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) 1 <br />COUNTY: Garfield <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 cun•ent 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 />ma . If no new disturbances or reclamation have occurred durinc the previous vear 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: Mitch Nachtigall <br />Permittee Name: Colorado Lien Company <br />Address: P.O. Box 440 <br />Rapid City, SD 57709 <br />Phone Number: (605) 342-7224 <br />Fax Number: (605) 394-7246 <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 />5~.,~~~- <br />Signature of Corporate Officer, Owner, or Designee <br />9 /o-c7 <br />Date <br />RECEIVED <br />SEP 13 2001 <br />Divialon of Reclamation, <br />Mining and Safety <br />