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~ ~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Rio Blanco County <br />1977-136 <br />Prather Pit <br />February 23, 2007 <br /> <br />DEB 15 211111 <br />Divia~~.n " , :~, <br />iinin~ wu, , ,; ~~/ <br />$$688.00 (Due on or before your anniversary date) <br />Rio Blanco <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 />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 man 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 durinc the previous veer and no <br />new chances 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 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: David P. Morlan <br />Permittee Name: Ric Blanco Ccunty <br />Address: 570 2nd St. <br />Phone Number: <br />Meeker, CO 81641 <br />(970)878-9590 <br />Fax Number: (970) 878-3396 <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 />t <br />~ignature of Co lfor6le Officer, Owner, or Designee <br />~~3~ 9 <br />Date <br />M:~PERMI7INASTERDOCUMENTSNI-AF-04 <br />