REP43830

• Permit No: M1989003
• IBM Index Class Name: Report
• Doc Date: 4/12/2007
• Doc Name: Annual Rpt
• From: Kit Carson County
• To: DRMS
• Permit Index Doc Type: Annual Reclamation Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE an REPORT UEST
'Kit Carson County
~IGI--1989-003
Raymond Schulte Pit
Apri15, 2007
$$688.00 (Due on or before your anniversary date)
Kit Carson
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~ (v~inin~ tnd 3sf~iy
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the pennit, an
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
-- occur during the upcoming year,-reclamation that will be_performed during the coming year,_the dates. for the _
beginning of active operations, and the date active operations ceased for the year, if any.
Please- attach your revised written annual report and annual report map to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated map. If no new disturbances or reclamation have occurred durinti the previous vear and no
new chanties to the previous year's map are necessary, then no new map is required, provided that the
Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly
delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
PermitteeContact: >~m-Browttficld ~el~a rn ~~+-~~Adri M~ t^T.p~at,o ~ 8 Q~vc.E7
Permittee Name: Kit Carson County
Address: 251 15th St. wr ~ '~~/p
P.O. Box 160
Burlington, CO 80807
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or Mach it to this form ~lpng~}vith your written report and map. Annual Report instructions are
Officer, Owner, or Designee
~- y -o
Date
3 f / f (n M:~PERMI'IINASTERDOCUMENT54N-AF-04