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/ / / ~ // <br />r <br />ANNUAL FEE and REPORT REQUEST <br /> '/ <br />PERMITTEE NAME: R}o Blanco County <br />PERMIT NO.: M-1978-002 <br />OPERATION NAME: Texas Creek Pit <br />ANNIVERSARY DATE: February 23, 2007 <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />COUN'T'Y: Rio Blanco <br /> <br />I~ :~;~ ;~= ^ 4 A,^^ <br />D~o B 1 .5 ,n07on <br />fvunmg a::_ Sc ~~,~ <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`sshall submitKhe annual- ee`, a report and map showih~xtent of current~isnubances 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 vour revised written annual report and annual reuort mau to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinc the previous year and no <br />new chances to the previous year's man are necessary, then no new mao is required, provided that the <br />Operator shall state this in the Annual Resort. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: David P. Morlan <br />Permittee Name: Rio Blanco County <br />Address: 570 2nd St. <br />Phone Number: <br />Fax Number: <br />Meeker, CO 81641 <br />qo <br />(970)878-9579 <br />(970)878-3396 <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 />ignature of Corpor e Officer, Owner, or Designee <br />/~/~ <br />Date <br />M: W ERMmMAST[;RD000M ENTSNI-AF-04 <br />