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<br />{~~F ~- ~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPJERSARY DATE: <br />ANNUAL FEE DUE: <br />ANNUAL FEE and REPORT REQUEST <br />Butala Construction Company <br />M-1977-170 / <br />Butala Gravel Pit <br />October 1, 2007 <br />$$791.00 (Due on or before your anniversary date) <br />RECEIVED <br />SEP 2 7 2001 ~ <br />Division of Reclamation <br />Mining and Safety <br />--- -.-COUNTY: - _ _ ,__ _Chaffee-- _--- _ -- --- -- - ~___. --- -_- _ - _ <br />_ _ _According,to C.R.S_ 34-3?.5-116_ or C.R.S,_34_32,116, each year,.on the annivers_ary._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 />man. If no new disturbances or reclamation have occurred during the previous vear and no new chances to <br />the previous year's map are necessary, then no new man 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 permittee contact infonnation. Please verify and make any necessary <br />changes: <br />Permittee Contact: Frank Butala <br />Permittee Name: Butala Construction Company <br />Address: 9000 CR 152 <br />Salida, CO 81201-9519 <br />Phone Number: (719) 539-2521 <br />Fax Number: (719) 539-2523 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~~ ~ ~ ~~ ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />9/ZS /07 <br />Date <br />