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l~ <br />ANNUAL FEE and REPORT RE UEST ,,~~ <br />I~~'~~,/ <br />PERMITTEE NAME: McAtee Construction Co. ~°° "~ <br />/ DES ®72001 <br />PERMIT NO.: M-1986-147 / piVisi®n oy~ <br />RecOametio <br />OPERATION NAME: Harley Pit #1 Nlm'ng and Safety n' <br />ANNIVERSARY DATE: December 2, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Logan <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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />_.._ -- reclamation-accompli-shed-to -date-and during the--preceding year,- new disturbances_-that _are..anticipated_to.-occur__- __- _ _. <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />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. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suffrce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ~-f:-1=;~irer~- <br />Permittee Name: McAtee Construction Co. <br />Address: P.O. Box 1908 <br />/~/,t rren CT ~ w/ <br />A~ ~ ~P ~" <br />~` `Sterling, CO-807 <br />Phone Number: <br />(970)521-0651 <br />Fax Number: <br />(970)522-9725 <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 enclosed. <br />~~.ti ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />/I-G-off <br />Date <br />