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<br />~: <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~4~ ; le 1° <br />ANNUAL FEE and REPORT REQUEST <br />Kirkland Coustructiou, RLLP <br />-~1CI-1998-038 <br />Two Rivers <br />August 3, 2007 <br />$791.00 (Due on or before your anniversary date) <br />Pueblo <br />o~c,._. <br />R~~ ~ ~~D <br />`AUG 15 2007 <br />Division of nzc~arc~afion, <br />,~ Mining and Safety <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 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 far the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new chances to <br />the previous year's map are necessary, then no new map is renuired, provided that the Operator shall state <br />this in the Annual Report. 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: Joe C. Baxter <br />Permittee Name: Kirkland Construction, RLLP <br />Address: 2101 Main St. <br />P.O. Box 580 <br />Rye, CO 81069 <br />Phone Number: <br />Fax Number: <br />(719)489-3385 <br />(719)489-2265 <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 />Sign re of Corporate Officer, Owner, or Designee <br />S'- 3 d '/ <br />Date <br />