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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />_~ <br />ANNUA~ E and / ORT REQUEST <br />Schmidt Construction Company <br />N -1988-044 <br />Coal Creek Resources <br />March 28, 2007 <br />RECEIVED <br />-MAR 21 2007 <br />Division of ReelamadtM, <br />~INining and Safety <br />$$688.00 (Due on or before your anniversary date) <br />Arapahoe <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submi[_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 since for a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Pennittee Contact Scott Davis <br />Permittee Name: Schmidt Construction Company <br />Address: 2635 Delta Dr. <br />Colorado Springs, CO 80910 <br />Phone Number: (719) 392-4207 <br />Fax Number: (719) 392-4245 <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. Annua] Report instructions are enclosed. <br />- ~-~~ ~ X °~'26~ ~ ~f~ <br />Signa~ure ofCorporate O rcfY~ e Owner, or Designee <br />~-/~-dam <br />Date <br />