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~~~~~~ <br />ANNUAL E and REPORT REQUEST <br />PERMITTEE NAME: Weld County <br />PERMIT NO.: 1980-121 ~,,~•7 ? `~ , ; 7~ <br />OPERATION NAME: Pierce Pit ~`~ ' ' ' ~'~ <br />IYuOL7 ' ~'~'~~~ <br />9 F.iIG J]~riy <br />ANNIVERSARY DATE: March 1, 2007 <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) <br />COUNTY: 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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances 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 renort map 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 durin¢ the previous vear and no <br />new changes to the urevious year's map are necessary. then no new map is required, provided that the <br />Oaerator shall state this in the Annual Report. 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: Greg Nelson <br />Permittee Name: Weld County <br />Address: 1111 H St <br />P.O. Box 758 <br />Greeley, CO 80632 <br />Phone Number: (970) 356-6496 <br />Fax Number: (970) 304-6497 <br />If you have additional comments and/or infonnation that should be provided to the Division, please provide it <br />below or attach it to this fonn along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Co orate Officer, Owner, or Designee <br />o2,~r~ eZ//~ 7 <br />Date <br />M:~PERMI'IVNASrERDOCUMENTSNI-AF-04 <br />/~ <br />