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<br /> <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Pueblo County <br />M-1997-081 <br />Everhart Pit <br />March 3, 2002 <br />RECEIVED <br />MAR 1 12ppp <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Pueblo <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, ^ew disturbances that'aze 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 report map to this form. Please note that an <br />adequately Labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Patricia K. Coffee <br />Permittee Name: Pueblo County <br />Address: 33601 United Ave. <br />Pueblo, CO 81001 <br />Phone Number: <br />Fax Number: <br />(719)583-6040 <br />(719)948-9641 <br />If you have additional comments and/or information that should be provided to [he 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 />Signature of Corporate Officer o ner <br />oj~{1 /off <br />Date <br />M'~PERM77'~MASTERDOCUMENTSU~I-AF-04 <br />