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i <br />.1~ <br />.. ~ <br />~cor mg to - 23=I1`6 o`r-C:R~S:3432=TIG, each-year; on ffie aiinrversary da~'e -o£"the perm7f,`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 resort and annual report maa to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated mau. If no new disturbances or reclamation have occurred durine the previous year and no <br />new changes to the previous year's map are necessary. then no new map is required. provided that the <br />Ouerator 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: ~d- <br />Permittee Name: Kit Carson County <br />Address: P.O. Box 160 <br />Burlington, CO 80807 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />rr'~ct1/F~ <br />ANNUAL FEE and REPORT REQUEST A~~ 2 2 2~~]1 <br />Division of Reclamation, <br />Kit Carson County Mining and Safety <br />M-1991-071 <br />Bohnen Pit <br />September 6, 2007 <br />$$323.00 (Due on or before your anniversary date) <br />Kit Carson <br />Phone Number: (719) 346-8139 <br />Fax Number: (719) 346-7242 <br />~~~w~ <br />~'~RD(, ~ ~2~rz <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 />Cam ~ ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />M:~PERMITMASTERDOCUMENTSVv7-AF-04 <br />