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~S C <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />r// %/ ~~ / <br />ANNUAL FEE and REPORT REQUEST <br />" Larimer County <br />~ M-1985-135 <br />Horton Gravel Pit <br />January 31, 2008 <br />'®~C ? ~ 201 <br />/Division o~ ~'Pciamation, <br />Mini;fa anc= safety <br />$$791.00 (Due on or before your anniversary date) <br />Larimer <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 o cf urrent~is~urbanc~ e~ffected~- --- <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. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new chances to the previous year's map are necessary, then no new map is required, provided 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Dennis C. Morrison <br />Permittee Name: <br />Address: <br />Larimer County <br />P.O. Box 1190 <br />Fort Collins, CO 80522 <br />Phone Number: (970) 498-5652 <br />Fax Number: (970) 498-5678 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />elow or attach it to this form along with your written report and map. Annual Report instructions are <br />enclo d. <br />~~. <br />Signature of Corporate Offi r, Owner, or Designee <br />Date <br />M:~PERMITIMASTERDOCLTMENTSVvI-AF-04 <br />