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<br />ll:_ - , <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />R M Hiner Construction Co., Inc. <br />M-1977-151 <br />Greeley Pit <br />January 30, 2006 <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 year, on the anniversary date of the permit; an operator <br />s a su mrt t e annua ee, a report an -map s owing t e exten o cu£' nenf-d s'-t-urbances f-o 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 year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anm~al report and annual report map to this form- Please note that an <br />adequately labeled map that clearly 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: 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 are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />January 3, 2006 <br />Date <br />