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/~~ .`~~~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />/General Operating Company <br />t/M-1979-034 <br />Gardner Gravel Pit <br />May 26, 2007 <br />$$688.00 (Due on or before your anniversary date) <br />Routt <br /> <br />t/ ~""~' ~:i%~u7 <br />D':~, <br />fviini,i ~ `icu, <br />_~~~ S~r;;;y <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operator <br />shall submit the annual fee; a report and inap showing the extent of currattt 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 report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, reuort, and associated <br />map. If no new disturbances or reclamation have occurred during the previous vear and no new chances to <br />the previous year's mao are necessary. then no new mao is required, provided 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 informafion. Please verify and make any necessary <br />changes: <br />Permittee Contact: Dan Redmond <br />PermitteeName: Genera]OperatingCompany /VO CNA/JCz1=5 <br />Address: P.O. Box 223 <br /> Yampa, CO 80483 <br />Phone Number: (970) 736-1137 <br />-Fax Number: -- -- --- - - -- - - <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below o tt it this form along with your written report and map. Annual Report instructions are enclosed. <br />Si ture of rate Officer, Owner, or Designee <br />Date <br />