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w <br />//~~~/ / <br />ANNUAL FEE and REPORT REQUEST <br /> ~ <br />PERMTTTEE NAME: ~ Las Animas County " ` <br />C~~~~D <br />PERMIT NO.: t~M-2000-053 SUN Y 4 2001 <br />OPERATION NAME: Castillo Pit Di/ysion of Reclamation, <br />~/iDli <br />i <br />ANNIVERSARY DATE: June 12, 2007 n <br />ng and Safety <br />ANNUAL FEE DUE: $$688.00 (Due on or before your a nniversary date) <br />COUNTY: Las Animas <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-cun•ent-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 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 your revised written annual report and annual report man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. I_f_no new disturbances or reclamation have occurred durinc the previous year and no <br />new chances to the previous year's man are necessary. then no new mau is required. provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Phil Dorenkamp <br />Pennittee Name: Las Animas County <br />Address: 2000 N. Linden Ave. <br />- --- Trinidad, CO 81082 <br />Phone Number: (719) 846-2931 <br />Fax Number: (719) 846-0434 <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 <br />e sed. <br />I~ <br />i afore of Corporate O icer, Ow~i r, or Designee <br />Date <br />M:~PERMI'11MASTERDOCUMENTSNI-AF-0O <br />