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-, <br />~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~.f I <br />ANNUAL FEE and P',EPORT RE VEST <br />Fremont County <br />,/1GI-1984-117 <br />Fremont Gravel Pit <br />January 20, 2008 <br /> <br />~~~~~~~ <br />Division or 44sclamation, <br />~ Mining a..c ~ afiety <br />$$323.00 (Due on or before your anniversary date) <br />Fremont <br />~__According_to C.R.S. 34-32,5_116 or C.R.S. 34-32-116, each year, on_th_e 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. 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 changes 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: Paul Garrett <br />Permittee Name: Fremont County <br />Address: 615 Macon Ave., Rm. 105 <br />Canon City, CO 81212 <br />Phone Number: (303) 942-4234 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attac it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corp ate Officer, Owner, or Designee <br />Iz//s/7 <br />Date <br />M:~PERMITIMASTERDOCUMENTS~Iv1-AF-04 <br />