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PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~- <br />R~x~~ <br />ANNUAL FEE and REPORT REQUEST <br />APC Southern Construction Co., LLC RECFi~i~~ <br />M-2000-118 / <br />Pino Pit ~~ 2 2 2007 `~ <br />Division of Reclamation, <br />November 15, 2007 Mining and Safety <br />$$791.00 (Due on or before your anniversary date) <br />Huerfano <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 />shall submit the annual fee, a`report and-map showing the extent of cun•ent disturbances to 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 vour revised written annual resort and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />ma . If no new disturbances or reclamation have occurred during the nrevious vear and no new chances to <br />the nrevious year's man are necessary, then no new man is required, provided that the Onerator shall state <br />this in the Annual Renort. 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: Richard Pounds <br />Permittee Name: APC Southern Construction Co, LLC <br />Address: P.O. Box 969 <br />Penrose, CO 81240 <br />Phone Number: (719) 372-6974 <br />Fax Number: (719) 372-3047 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />b(e~or attar t to this Form alongg with your written report and map. Annual Report instructions are enclosed. <br />Signature of ~'orporate Off~cer, Owner, or Designee <br />l`~ °~~o~ <br />Date <br />