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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />/~ ~~ ~ ~ <br />ANNUAL FEE and REPORT REQUEST <br />(Duckels Construction, Inc. <br />~1GI-1976-051 <br />Bettger Gravel Pit <br />May 8, 2007 <br />$$688.00 (Due on or before your anniversary date) <br />Routt <br />«~,~,., r~ <br />~_~.-. - ~ ~~' A <br />" J.~, ~i ~ ~ ~~~~ <br />,;,a <br />- f~„~J~~,, ~a~ ;L :~ <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 axten`t of curierit 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 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 resort maa to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map 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 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: Fred A. Duckels <br />Permittee Name: Duckels Construction, Inc. <br />Address: 3500 Duckels Ct. <br />Steamboat Springs, CO 80487 <br />Phone Number: (970) 879-6072 <br />Fax Number: (970) 879-6748 <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 />1 - <br />Signature of fporate fic O er, or Designee <br />_~- ~ ~ 0'1 <br />Date <br /> <br />