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/91~ ' /~ ~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />/Pinneo Feedlot, LLC <br />-1980-135 <br />Headley <br />October 7, 2007 <br />RECEIVED <br />~p~ p 4 2007 <br />~sion of Reclamation. <br />WUnln9 and Salary <br />$$791.00 (Due on or before your anniversary date) <br />Morgan <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'tfie 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 vour 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: feb, report, and associated <br />man. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to <br />the previous year's map are necessary, then no new map is required, urovided that the Ouerator shall state <br />this in the Anuual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Joel Chisum <br />Permittee Name: Pinneo Feedlot, LLC <br />Address: 32295 Awy 34 <br />P.O. Box 384 <br />Brush, CO 80723 <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 />~ ~~~~ . ~ <br />Signature of Corporate Officer, Owner, or Designee <br />~d~~/47 <br />Da~-~ <br />(970) 842-0701 <br />