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ANNUAL FEE and REPORT REQUEST oer`eI~/I=D <br /> AUG 2 4 2001 <br />PERMITTEE NAME: Gunnison County <br />Division of rZeclamation, <br /> Mining and Safety <br />PERMIT NO.: M-1991-104 <br />OPERATION NAME: Nicolas Pit <br />ANNIVERSARY DATE: September 17, 2007 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversa ry date) <br />COUNTY: Gunnison <br />- -- --According Q: ^:R:S-34-32:~ li6-ar-C-.R:S-3432-I16,-eacl. yea~orrthe-aruiiversary date uf'the permit,-ari -' <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 yeaz, new disturbances that are anticipated to <br />occur during the upcoming yeaz, 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 report 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 durinti the previous year and no <br />new chanties to the previous year's map are necessary, then no new map is required, provided that the <br />Operator 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: <br />Mazlene Crosby <br />Permittee Name: <br />Address: <br />Gunnison County <br />811 Rio Grande <br />Gunnison, CO 81230 <br />Phone Number: (970) 641-0044 <br />Fax Number: (970) 641-8120 <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 />tore of Corporate Officer, Owner, or esignee <br />8)q)c~7 <br />Date <br />M:~PERM77~MASTERD000MEN'fS~M-AF-04 <br />