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~~~ <br />Flo, hhP <br />PERMITTEE NAME: Saguache County <br />PERMIT NO.: M-1984-044 ~~~i ~t <br />OPERATION NAME: San Isabel Pit <br />ANNIVERSARY DATE: June 11, 2005 JUN 2 7 2~~ <br />ANNUAL FEE DUE: $688A0 (Due on or before your annpt~raanyntl~e~ and Geology <br />COUNTY: Saguache <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 shall submit the annual fee, _a report and map showing the extent of current distwbances 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 the date active operations ceased for the year, if any. <br />Please attach ynnr reyis d written annual r ,Port and anm~al rvpnrt 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: rr <br />Permittee Contact: John Ungefug ~t~d W }~ ~ r r e d O k ~. O <br />Permittee Name: Saguache County <br />Address: P.O. Box 655 <br />Saguache, CO 81149 <br />Phone Number: (719?.655-2554 <br />Fax Number: (719) 655-2543 <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 />~~~ <br />Stgnanture of Corporate Officer, Owner, or Designee <br />vie ~ 3 . ~-~ ~ ~ <br />Date <br />M:~PERMI7IMASTERDOCUMEMS~M-AF-D4 <br />