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e~ ~' <br />~~ehh~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />First Bentonite Company Colorado <br />M-1977-231 <br />LBC Bentonite Pit <br />August 23, 2005 <br /> <br />JUL 2 7 2005 <br />~IYI§19fl fll ]H~liBfu^i3 & GeD10yy <br />$281.00 (Due on or before your anniversary date) <br />Fremont <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 I <br />shall-ssubmit-the annual=fee,=a=report=and=map=showing=the=extent-of-current- 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 ynnr revised written anmial re_pn and annual re_pnrt main to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Pamela Wedige <br />Permittee Name: First Bentonite Company Colorado <br />Address: 215 Teller St. <br />Phone Number: <br />Fax Number: <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 Offic r, wn r, or Designee <br />D~~~~ <br />Salida, CO 81201 <br />(719)539-4693 <br />