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• :~ - <br />PERMTTTEE NAME: <br />PERMTI' NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANI ~~ 1kE and ~ RT REQUEST <br />Montrose County <br />~-1992-017 <br />BLM/West End Pit <br />April 24, 2007 <br /> <br />N Y~~ <br />~''!/ 9 ~~ <br />~ z ~~oo> <br />ling and Sa/e~ bry <br />$$688.00 (Due on or before your anniversary date} <br />Montrose <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 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 vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the fallowing components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinc the previous vear and no <br />new chances to the previous year's map are necessary, then no new map 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 suffice jor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Brian Wilson <br />Pennittee Name: Montrose County <br />Address: <br />Phone Number: <br />Fax Number: <br />v-~-a~T VVVT[8ci[a ITN; Gin eEe~a,~~~ <br />/ to l S j~,.y ns er,cy~ue, <br />Montrose, CO 81401 <br />-/~J~4?~ 5~i} 2 - 75 <br />-7761 <br />7D - ~ 5-~- 70 o~c <br />97o-~S~- 7070 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it t this form along with your written report and map. Annual Report instructions are <br />ed. <br />' - <br />Signa~e of Corporate Officer, Owner, or Designee <br />~i~ /o~ <br />D e <br />M:~PERM11lMA5CERDOCUMEMSU4-AP-04 <br />