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~~- <br /> <br /> <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />September 11, 2006 <br />/~ <br />R'~~'~90/ED <br />/pilr, ~ 3 2006 <br />/Division of Reclamation, <br />Mining and Safety <br />$688.00 (Due on or before your anniversary date) <br />Baca <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 <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 vour revised written annual resort and annual resort map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Troy Crane <br />Permittee Name: Baca County <br />Address: 741 Main St. <br />Springfield, CO 81073 <br />Phone Number: (719) 523-6532 <br />Fax Number. (719) 523-6584 <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 a of Corporate Officer, Owner, or Designee <br />Dale <br />Gravel Pit No 8 <br />ANNUAL FEE and REPORT REQUEST <br />1/ Baca Couuty <br />~M-1977-485 <br />M:~PERMITVv(ASTERDOCUMENTS~ht-AE-04 <br />