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<br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Ronald L Barrier RECEI VE® <br />PERMIT NO.: M-1994.081 DEC 2 0 1002 <br />OPERATION NAME: <br />ANNIVERSARY DATE: Peat Mine <br />December 21, 2002 Oiuision of Minerals and Geology <br />ANNUAL FEE DUE: $550.00 (Due on or before your a nniversary date) <br />COUNTY: Alamosa <br />According [o 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 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 [he date active operations ceased for the year, if any. <br />- Pease attach your revised written annual reuort and annual report maU to this form. Please note that an <br />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: Ronald L. Barrior <br />Permittee Name: Ronald L Barrier <br />Address: P.O. Box 3 <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-6994 <br />Fax Number: (719) 587-0495 <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 />ignature o Corporate Officer, Owner, or Designee <br />Date <br />M:~PERMITMASTERDOCUMENTS/M-AF-02. DOC <br />