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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 />Bent County <br />M-1983-178 <br />Bent County Pit <br />November 2, 2006 <br />~~ r'" ~ -' ~ :~ <br />_ _'~ <br />NOV 01 ZO~~ <br />Division of Recla~e~;~n. <br />Mining ;,,;~ ~~; . ~ <br />$688.00 (Due on or before your anniversary date) <br />Bent <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, eac~ear~on the anniversarydate of the permit,_an_ <br />operator shalll sulimit 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 your revised written annual reuort and annual reuort maa to this form, The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, resort, and <br />associated mau. If no new disturbances or reclamation have occurred during the previous year and no <br />new chances to the previous year's map are necessary, then no new map is required, 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gary Pritchard <br />Permittee Name: Bent County <br />Address: P.O. Box 350 <br />Las Animas, CO 81054 <br />Phone Number: (719) 456-2223 <br />Fax Number: (719) 456-0375 <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 />~.n.~/ Q <br />Signature of Corporate O icer, caner, or esignee <br />J O _ ! ce - ~-Oo ~ <br />Date <br />M:~PERMITMAS7ERD000MENTS~hl-AF-04 <br />