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~'>~'~i <br />A AL FE and REPORT REQUEST <br />PERMITTEE NAME: ~ Thompson Properties <br />PERMIT NO.: ~-1983-102 <br />OPERATION NAME: Thompson Resource aka Horn Gravel Pit <br />ANNIVERSARY DATE: August 2, 2007 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Grand <br />o/G <br />_ Ec~,~ <br />..~ ~ ~D <br />o;v;sroUC 31 Z~~I <br />M~n~n9 and Safety °n, <br />According to C.R.S. 34-32.5-I 16 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 yeaz, the dates for the beginning <br />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 map to this form, The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the previous year's map are necessary, then no new map 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Lar/ry Tho pson <br />.~f . ~ t - <br />Thompson Properties ~~AA -IQ~ <br />P.O. Box 3 ~~ Y ((~"" <br />Granby, CO 80446 I ~~~ <br />i t-~~n ~. c~c~. <br />(970) 887-3710 <br />(970)887-2428 <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 />sl _ ~~ i <br />igna a of Corporate Officer, Owner, or Designee <br />~5~7 <br />Date <br />