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rn~ <br />r~~ <br />ANNUAL FEE and REPORT REQUEST <br />CEE NAME: <br />NO.: <br />ION NAME: <br />RSARY DATE: <br />FEE DUE: <br />t~0uray County <br />~M-1978-268 <br />Dallas Gravel Pit <br />March 22, 2006 <br />RECE~~" <br />APR y 4.2006 <br />OI 11tii18fSi~ u.i3 ~....uUR: <br />$688.00 (Due on or before your anniversary date) <br />Ouray <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 disturbances to affected <br />land, reclamation accomplished to__date and during the_preceding-year~new_disturbances that aze anticipated to_.,__- _ <br />- ~ - <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 />ch vour revised written annaal report and annual report map to this form. Please note that an <br />labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />records indicate the following permittee contact information. Please verify and make any necessary <br />Permit tee Contact: Chris Miller <br />Permit tee Name: Ouray County <br />Addre s: P.O. Box 456 <br /> Ridgway, CO 81432 <br />Phone Number: (970) 626-5391 <br />Fax N umber: - (470)•626-4439 '-~ -- - - - - - <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 />of Corporate Officer or Owner <br />