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,� • �, III IIIIIIIIIIIIIIII ' <br /> (41-2S� <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Rio Blanco County RECEIVED <br /> PERMITNO.: M-1978-002 FEB 16 2001 <br /> OPERATION NAME: Texas Creek Pit <br /> ANNIVERSARY DATE: February 23,2001 Division at Minerals and Geology <br /> ANNUAL FEE DUE: $281.00(Due on or before your anniversary date) <br /> COUNTY: Rio Blanco <br /> According to C.R.S. 34-325-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br /> operator shall submit the annual fee, a report and map showing 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 perforated during the coming year, the dates for the <br /> beginning 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. 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: -JrrrrS1rele Ron Leeper <br /> Permittee Name: Rio Blanco County <br /> Address: -P9-Box-Yd4 570 Second Straat <br /> Meeker, CO 81641 <br /> Phone Number: (970) 878-5601 <br /> Fax Number: (970) 878-3396 <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 <br /> enclosed. <br /> Signature of Corpora e Ot cer or Owner <br /> a --off 0 1 <br /> Date <br /> M�PERMITUASTERDOCUN1ENTSU-AF-04 <br />