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ANI~A~FEE a~d ~ ~ T REOIJEST p <br />REC <br />PERMITTEE NAME: ~ Diana K. Watson E-~ED <br />PERMIT NO.: iI~I-1981-275 ~FEB 2 8 2007 <br />OPERATION NAME: Stout -Amick Pit --wMlnin °f Reclamation, <br />9 and Safety <br />ANNIVERSARY DATE: March 5, 2007 <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) <br />COUNTY: 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 operator <br />- -shall-submit-the annual- fee,-a-report-and-map-showing-the-extent-of-current disturbances-to affeeted-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 />maD. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, 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: Diana K. Watson <br />Permittee Name: <br />Address: <br />Phone Number: <br />Diana K. Watson <br />P.O. Box 1056 <br />Meeker, CO 81641 <br />(970) 878-5898 <br />Fax Number: (970) 878-4523 <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 Officer, Owner, or Designee <br />~~,u~r~~ .~ 6, ono ~ <br />Date l <br />