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PERMITTEE NAME: Huerfano County <br />PERMIT NO.: M-2001-106 <br />OPERATION NAME: Orlando Pit [;~~ Q `~ LLB-~ <br />ANNIVERSARY DATE: December 18, 2004 _ _ , <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Huerfano <br /> <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 ynnr revised written annual report and annnal report ma=n, to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bill Brunelli <br />Permittee Name: Huerfano County <br />Address: 401 Main St.. Ste. 201 <br />Walsenburg, CO 81089 <br />Phone Number: (719) 738-2420 <br />Fax Number: (719) 738-3996 <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 <br />enclosed. <br />Designee <br />/~-l~-0~ <br />Dale <br />MIPERMITMASTERDOCUMENTSVN-AF-04 <br />