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REGEB V~'® <br />FFB 0 9 2006 <br />ANNilAi. FF.F and RF.P(1RT RF.OiTFST <br />Qivisian o(iNinorals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Diana K. Watson <br />M-1981-275 <br />Stout -Amick Pit <br />March 5, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Rio Blanco <br />According to C.R.S. 34-32.5-I 16 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 cunent disturbances to affected land, <br />reclamation accompli. homed to dat~and_durittg_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 attachs+nur revised written anneal rennrt and anneal rennrt man to thic form. Please note that an <br />adequately labeled map that clearly 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: <br />Permittee Contact: Diana K. Watson <br />Permittee Name: Diana K. Watson <br />Address: P.O. Box 1056 <br />Phone Number: <br />Fax Number: <br />Meeker, CO 81641 <br />(970) 878-5898 <br />(970) 878-4523 <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. Annua] Report instructions are enclosed. <br />~~ ~~~~ <br />Signature of Corporate ficer, Owner, or Designee <br />,~~~;i ~~ <br />Date <br />