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~~ ~~ <br />PERMITTEE NAME: <br />PERMTI' NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />'/ANNUAL FEE and REPORT REQUEST <br />'~ Kit Carson County <br />t~ M-1998-060 <br />Dorsch Pit <br />September 9, 2006 <br />~~'~'kw ~~^~~ `~ <br />`~NOV 0 1200 <br />Division of Reclamation, <br />Mining and Safety <br />$281.00 (Due on or before your anniversary date) <br />Kit Carson <br />~~ ~Y ~ <br />~)~ D~-CL <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I16, 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 />]and, 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 mau to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since 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: Lyn Brownfield <br />Permittee Name: Kit Carson County <br />Address: P.O. Box 160 <br /> Burlington, CO 80807 <br />Phone Number: (714) 346-8139 - - - - <br />Fax Number: (719) 346-7242 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it ty~tis form along with your written report and map. Annual Report instructions are <br />~~,~~ <br />or <br />Date <br />M:~PERMI7IMASTERDOCUMENTSUI-AF-04 <br />