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R j <br />/"/'/ <br />/D -/b -Ofv <br />gS~ <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 />~ Montrose County <br />~M-1987-151 <br />Soderquist Pit <br />October 28, 2006 <br />RECEIVED <br />G' nrr n 2 ~nng <br />~~v~s~0n °f Reclamation, <br />Minin.4 and Safety <br />$281.00 (Due on or before your anniversary date) <br />Montrose <br />According-to-G:R.S. 34-32.5-1-16 or-C-.R:S. 34-32-116,-eaelx year;-on-the anniversary datc-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 year, new disturbances that are 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 man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, resort, and <br />associated map. If no new disturbances or reclamation have occurred during the previous vear and no <br />new chanties to the previous year's map are necessary, then no new map is reuuired, 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; <br />Permittee Contact: Brian Wilson <br />Permittee Name: Montrose County <br />Address: 161 S. Townsend <br />Montrose, CO 81401 <br />Phone Number: ~49~1 <br />Fax Number: (970) 252-7010 <br />91©-~ s~-7ov~ ~- <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach ' to this form along with your written report and map. Annual Report instructions are <br />ed. <br />Signa re of Corporate Officer, Owner, or Designee <br />c- / ~ ~~0~ <br />Dat~ <br />M:~PERMIIIMASTERDOCUMENTSVN-AF-04 <br />