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rh~~ <br />12~~ <br /> <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: ~ <br />Rio Grande Couuty ~ <br /> // <br />PERMITNO.: ;/M-1978-071 ~ . <br /> <br />OPERATION NAME: r. <br />Del Norte Gravel Pit ~plvt . ~ `~ j; , „ <br />s <br /> <br />ANNIVERSARY DATE: oon o... <br />November 25, 2006 ft?'ntn9°nG~ yi <br />oa <br /> y <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Rio Grande <br />-- -- -According-to-C.R:S-34=32:5=1'Y6-ar C:IttS. 342=I'1">(, eacfi-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 the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual reuort man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated man. If no new disturbances or reclamation have occurred durinc the arevious year and no <br />new chances to the urevious year's map are necessary, then no new map is required, urovided 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 petmittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Patrick Sullivan <br />Permittee Name: Rio Grande County <br />Address: 168 N. Washington <br />Monte Vista, CO 81144 <br />Phone Number: (719) 852-4781 <br />Fax Number: (719) 852-0305 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below o ach it to this form along with your written report and map. Annual Report instructions are <br />e osed. <br />tgnature of Corporate Officer, Owner, or Designee <br />z ~ ~Oll CAP <br />Date <br />M:~PERMITNIASTERD000MENTSNr-AF-04 <br />