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~~ ~~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Logan County- <br />M-1978-146 v <br />Stephens Pit <br />October 1, 2007 <br />RECEIVED <br />/SEP 1 `L 2001 <br />~a/o' 6Aining and Sale1Y n, <br />$$791.00 (Due on or before your anniversary date) <br />Logan <br />- According to-C:R:S-34 32-5-i-Kt°~r n c zn_zo ~ ~~ >~~~ annivercarv dat .ne f th~_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 aze 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 report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous vear and no <br />n_ew changes 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: I> ~ ,{ _ / <br />Permittee Contact: cEonttiek {~ `f5 /` ~Q~A ( E?.f` <br />Permittee Name: Logan County <br />Address: 315 Main St., Ste. 2 <br />Sterling, CO 80751 <br />Phone Number: ~s-ro Q ~-O .~ Z Z ~ g ~"~ <br />Fax Number: (970) 522-4018 <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 />Si afore o Corpor e Officer, Owner, or Designee <br />Date <br />M:~PERMINNASTERDOCUMENTS~M-AF-04 <br />