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~y~~Pl <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 />City of Colorado Springs <br />~M-1992-074 <br />Clear Spring Ranch Pit <br /> <br />RE~~IVE® <br />iMAR 0 9 2007 <br />Division of Reclamation, <br />Mining end Safety <br />March 12, 2007 <br />$$688.00 (Due on or before your anniversary date) <br />EI Paso <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 ithe 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 man to this form. The Annual <br />Report & Fee requirement is not met until we tiave received the following components: fee, report, and <br />associated mao. If no new disturbances or reclamation have occurred durinc the previous year 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 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: I3:ebeoca-rt--Navies-, <br />Permittee Name: City of Colorado Springs <br />Address: P.O. Box 1103 Mail Code 940 <br />Colorado Springs, CO 80947 <br />Phone Number: ~iif9j-6fr8~672-' <br />r <br />,~EN>Uv A. GR~y <br />~'I i4) ~ c~ ~~ - 8 s 75 <br />Fax Number: (719) 668-8666 <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 />Sign tore o orporate fficer, Owner, or Designees <br />3~~ ~~ ~ ! <br />Date <br />M:~PERMITMASTERD000MENTSNI-AF-04 <br />