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ANNUAL FEE and REPORT REpUEST <br />PERMITTEE NAME: <br />PERMTI' NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~ Gary Boyce <br />~ M-1985-085 <br />Rancho Rosado <br />April 17, 2007 <br />~~ <br />~~v, <br />ti <br />o;~~ R ~ <br />.~i~;~°nQa asas0oo <br />$$688.00 (Due on or before your anniversary date) <br />Saguache <br />According to C.R.S. 34-32.5-1 l6 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 cun•ent 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 thatwill-be-performed-ducing_the coming_year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. - <br />Pease attach your revised written annual reuort 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 />maP. 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. arovided 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: Gary C. Boyce <br />Permittee Name: Gary Boyce <br />Address: 17425 CR 66T <br />Phone Number: <br />Fax Number: <br />Moffat, CO 81143 <br />(719) 256-4613 <br />(719)256-4318 <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 />_,r ~o ~~iv~Ty ,~. ~ooG t <br />ure Co ice , O er, or Designee N~ CCt(~n/GGS /f'r S/ / I_ , <br />/ / ~~.P/L n~~ <br />Date <br />