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Dqlcs <br /> 999 <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> PERMITTEE NAME: R M Hiner Construction Co., Inc. JAN 19 2001 <br /> PERMIT NO.: M-1977-151 Divift of Miner.': Sad Geology <br /> OPERATION NAME: Greeley Pit <br /> ANNIVERSARY DATE: January 30,2001 <br /> ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br /> COUNTY: Weld <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 /> adegualely labeler( map that clearly delineates and includes the above elements may suffice,/or a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: all information below is correct. <br /> Permittee Contact: Rex M. Hiner <br /> Permittee Name: R M Hiner Construction Co., Inc. <br /> Address: 2220"O" St <br /> Greeley, CO 80631 <br /> Phone Number: (970)356-2660 <br /> Fax Number: (970)256-2662 <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 /> .1 G- UU- b-k <br /> Signature of Corporate Officer or Owner <br /> Sharon A Hiner, Co/owner—Sec/Treasurer <br /> January 18, 2001 <br /> Date <br /> \ M TERMITVAASTERDOCUNENTSNM-AF-01 <br />