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4 ~ ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Ldl'1l~ <br />~ANNiiAT, FF.F. and RF,PORT RF.(IiTF.ST <br />~/Lincoln County <br />v M-2000-066 <br />Raymond Enderson Pit <br />RECEIA.~E® <br />~~ JUN 13 2006 <br />Division of Mincrala end CealogY <br />July 12, 2006 <br />$281.00 (Due on or before your anniversary date) <br />Lincoln <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 distu"rliarices 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 Ynnr revised written anneal rennrt and anneal refit man 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: Don Blake <br />Permittee Name: Lincoln County <br />Address: P.O. Box 39 <br /> Hugo, CO 80821 <br />Phone Number: (719) 743-2337 <br />Fax Number: (719) 743-2815 <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 farm along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />~~ ~~~ ~~ <br />Date <br />M:~PERMITN1AS7ERD000MEMSM-A£-04 <br />