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<br />fl~ ~- RAT <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Thornburg Family Limited Partnership <br />PERMIT NO.: M-1983-060 t~ <br />OPERATION NAME; Thornburg Pit <br />ANNNERSARY DATE: September 27, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Adams <br />RECEtVEp <br />SEP ~ Q 2001 <br />~b~9 and ~ go„ `~t <br />~ ~1/ <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 the annual fee, a report and map showing the extent of cun•ent disturbances to affected land, <br />_ _ reclamation accomplished to date and during thereceding 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 your 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: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new chances to <br />the previous year's mau are necessary. then no new map is required. provided 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 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: Stanley Thornburg <br />Permittee Name: Thornburg Family Limited Partnership <br />Address: 50747 E. 38th Ave. <br />Phone Number: <br />Fax Number: <br />Bennett, CO 80102 <br />(303) 644-3424 <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 />Signature Corporate Officer, Owner, esignee <br />~, ~~ ~ ~'~ ~QZD7 <br />Date <br />