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i <br />• <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Weld County <br />PERMIT NO.: M-1987-186 <br />OPERATION NAME: Peters Pit No 2 <br />ANN[VERSARY DATE: March 1, 2001 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Weld <br />RECEI~'"~ <br />FEB 2 G ~~~~ <br />piYlsion of Miner:......_._,, <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 fnr the <br />beginning of active operations, and the date active operations ceased for the yeac;,if.any: .: i ~,.. <br />Please attach vour revised written annual report and annual report map to this form. please note tiros ar <br />adequately labeled map that clearly delineates and includes the above elements mny stjftce for a written <br />report. <br />Division records indicate the following petmittee contact information. Please verify attd make any necessary <br />changes: )/ <br />PermitteeContact: Greg Nelson C'/` <br />Permittee Name: Weld County <br />Address: P.O. Box 758 <br />Greeley, CO 80632 <br />Phone Number: (970) 356-4000 <br />Fax Number: (970) 304-6487 <br />If you have additional comments and/or ittfonnation 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 />Signatur of Corporate Officer or Owner <br />~~~a ~o~ <br />Date <br />M.NERMITUTASTE RDOCUt.~NTSVN ~AF-Od <br />