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14-~ ~ ~P~ <br />PERMITTEE NAME: . <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />//A/mericau Gypsum Company <br />Y141-1984-041 <br />Eagle-Gypsum Mine <br />December 24, 2006 <br />~°~/aloe <br />_ -~~~ <br />0 8 ~~~s <br />rrt~ion of ReclamaLo;., <br />Twining and Safety <br />$$688.00 (Due on or before your anniversary date) <br />Eagle <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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished_to_ date and during the preceding year, new disturbances that are anticipated_to_occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual renort and annual report mao to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />ma If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the arevious year's maa are necessary, then no new maa is required, arovided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Ray Barnes <br />Permittee Name: American Gypsum Company <br />Address: 740 U.S. Hwy 6 <br />Gypsum, CO 81637 <br />Phone Number: (970) 524-9700 <br />Fax Number: <br />If you have additional comments and/or information that should be <br />below or attach it to this fo along with your written report and map. <br />Signatur of Corp rate Officer, Owner, or Designee <br />z ~~~~, <br />Dat-e <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />