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v <br /> 999 <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> PERMITTEE NAME: Routt County MAR 21 2001 <br /> PERMIT NO.: M-1979-058 <br /> OPERATION NAME: Funk& Hooker Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: April 26,2001 <br /> ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br /> COUNTY: Routt <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, new disturbances that are 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 your 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 mat, 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: Louis G. Gabos <br /> Permittee Name: Routt County <br /> Address: P.O. Box 773598 <br /> Steamboat Springs, CO 80477 <br /> Phone Number: (970) 879-0831 <br /> Fax Number: (970) 879-3992 <br /> If you have additional comments and/or information that should be provided to the Division, please provide it <br /> below ttach it to this form along with your written report and map. Annual Report instructions are <br /> enclos d. <br /> I <br /> Signature of Corporate Officer or Owne <br /> 26 0 <br /> Date <br /> M.TERMT,MASTEMOCUMENTSIM-AF-04 <br />