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~~ ~- QQ~ <br />ANNUAL FEE and REPORT REQUEST ~,[/7 <br />I~/ <br />PERMITTEE NAME: Marilyn E. Vazquez, Bruce A. Diamond <br />PERMIT NO.: M-2000-099 <br />OPERATION NAME: Pit Number One <br />ANNIVERSARY DATE: February 9, 2008 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Chaffee <br />~~~°,~~ <br />FEB 0 6 Z~flf1~ <br />~rrr~run,~a; f~~ciUi?~~a~~on, <br />~rriing ~ctd.'Safety <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 />- - - - reclamatie::-accomplished--to-date ~d~during-the-preced#ng ;ear---rrev~L-distar~ar~s--thatar~e--anciuipate'd=t~~E~`ur=~--- <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 man are necessary, then no new man is reauired, 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: Marilyn E. Diamond <br />Permittee Name: Marilyn E. Vazquez, Bruce A. Diamond <br />Address: 26520 CR 301 <br />Buena Vista, CO 81211 <br />Phone Number: (719) 395-8631 <br />Fax Number: (719) 395-8670 <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 />Signa a of C orate Officer, Owner, or Designee <br />Q~~ oZ00~ <br />Date <br />