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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 />Seneca Coal Company t~ <br />i/ M-1982-036 ~j <br />Mesa Gravel Pit <br />v <br />~~C~~VE® <br />JUN 1 3 20~ <br />givision of Minerals and Geology <br />Jane 22, 2005 <br />$688.00 (Due on or before your anniversary date) <br />Routt <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 <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 yeaz, new disturbances that are anticipated to <br />occur during the upcoming yeaz, 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 voar revised written annual report and annual report map to this form. Please note that <br />an 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: <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Ilebet#Shevlieg <br />Seneca Coal Company <br />P.O. Box 670 <br />Hayden, CO 81639-067 <br />in^tm <br />(970)276-3014 <br />Roy A. Kara <br />Seneca Coal Company <br />P.O. Box 670 <br />Hayden, CO 81639-0670 <br />(970) 846-3648 <br />(970)276-3014 <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 />~~ ~P~- - - <br />Sign tore f Corp to Officer, Owner, or Designee <br />Date <br />