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<br /> ~~ ~- ~~ <br /> ANNUAL FEE and REPORT REQUEST <br /> <br />PERMITTEE NAME: Quarter Circle 8 LLLP <br />PERMIT NO.: M-1980-003 ,~ <br />OPERATION NAME: McNulty Cinder Pit <br />ANNIVERSARY DATE: January 23, 2008 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Eagle <br />~1~~~~~, f~,~ <br />J~~~~~ ~ !~ ~I~r~~ <br />Div~inir~U4~~'"~` r~dr;i~,2ian, <br />9 anc ~ ~.fQ4y /' <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 accompiYShed-to-riat~ and~zluring-tlz~3re~edirrgyear,-new tiisturb~r~~tliat~e ~rrtici~te~d~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 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: Sarah L. McNulty <br />Permittee Name: Quarter Circle 8 LLLP <br />Address: 7747 CR 100 <br />Carbondale, CO 81623 <br />Phone Number: (970) 963-4363 <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 attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Own , or Designee <br />~ 0~ <br />Date <br />~ ~ <br />(Cewc~ <br /> <br />