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JAN-29-2007 11:52A11 FROM-DIV RECLAMATION t11NING & SAFETY 3039329102 <br />b~ ~'~-' <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 />City of Walsenbutg <br />1V1-2000-092 <br />Walsenburg Gravel Pit <br />Aecember 14, 2006 <br />T-99B P.003/003 F-139 OZ~~-~ <br />~@ p ~200I ~ <br />~ry~s~°n or <br />Mining ana Sa cation <br />ty <br />$$281.00 (Due on or before your anniversary date} <br />Huerfano <br />According to C.R-S,34-32.5-116 or C.R,S. 3432-116, 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 year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed daring the coming year, the dates for the <br />beginnigg of active operations, and the date active operations ceased for Ste year, if any. <br />Please attach your revised written annual report and annual report map_to this form_ The Annual <br />Report & Fee requirement is not met until we have received the Pollowing components: fee, report, and <br />associated man. If no new disturbances or reclamation have occurred during the~trevious year and no <br />new changes to the previous year's map are necessary. they no new map is required, provided that the <br />pperator 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 />Q <br />Permittee Contact: Editfr'3ht:td'oiT^ .. E~ y'~ /~"~4 r S~,.l <br />Petmirtee Name: City of Walsenburg l ©Ce( i+lt -Y" S ~i F/o(s./ <br />Address: 525 S. Albert <br />Walsenburg, CO 81089 <br />Phone Number: -Fi}gj'f38St8~4S- 0~7/9'~ 73~'-1~:y0 ~x ~D r/ <br />Fax Number: (119) 735-1875 ~ 7/ ~ ~38'~- /D yd' <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 wrirten report and map. Annual Report instructions are <br />enclosed. <br />Signature o Co porate Officer, caner, or Designee <br />,~¢~~ ~ Zdr) 7 <br />Date <br />t,t,~rt~'tvunsrmuocun~a:rrrsvd-nroa <br />