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V <br /> ANNUAL FEE and REPORT REQUEST <br /> RECEIVED <br /> PERMITTEE NAME: Rio Blanco County JUL 12 2001 <br /> PERMIT NO.: M-1980-112 <br /> Division of Minerals and Geology <br /> OPERATION NAME: Richard Bachman Pit <br /> ANNIVERSARY DATE: July 10,2001 <br /> ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br /> COUNTY: Rio Blanco <br /> According to 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 the date active operations ceased for the year, if any. <br /> Please attach your revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following pemiittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: yes LEE-lok—� R <br /> Permittee Name: Rio Blanco County <br /> Address: P.O K St7D 2►. �l �}y)rG� <br /> Meeker,CO 91641 <br /> Phone Number: (970) 878-5601 <br /> Fax Number: (970) 878-3396 <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 /> Signat�Corporaleficer or Owner <br /> G - zt-01 <br /> Date <br /> M:IPERNI n\MASTERDOC U M ENTSNI-AF-61 <br />