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~t~s~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />'ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />~R M Hiner Construction Co., Inc. <br />~'M-1977-151 <br />Greeley Pit <br />January 30, 2007 <br />~Jae:~~ C 9 2006 <br />~SIIn of ia~:^':aq, <br />~ a~1 -;! <br />$$688.00 (Due on or before your anniversary date) <br />Weld <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 map showing the extent of current disturbances to affected land, <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 resort and annual resort maa to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />man. If no new disturbances or reclamation have occurred during the previous vear 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 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: Rex M. Hiner <br />Permittee Name: R M Hiner Construction Co„ Inc. <br />Address: 11 Austin Road <br />Lamar, CO 81052-4301 - ' <br />Phone Number: (719) 336-3467 <br />Fax Number: (719) 336-5031 <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 aze enclosed. <br />~~~1 ~~DIkR-~ <br />Signature of Corporate Officer, Owner, or Designee <br />8, 2007 <br />Date <br />