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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />ANNUAL FEE and REPORT RE VEST <br />Jeffrey L. Schumacher <br />M-2006-072 ~// <br />Schumacher Pit #3 <br />March 5, 2008 <br />B 0 8 2008 ~ ' <br />FE l/ <br />Division ota d Safety n <br />Mining <br />$$791.00 (Due on or before your anniversary date) <br />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_accomplished to date and-dur-ing -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 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: Jeffrey L. Schumacher <br />Permittee Name: Jeffrey L. Schumacher <br />Address: 831 Park St <br />Sterling, CO 80751 <br />Phone Number: (970) 552-6979 <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 />atu a of Corporate Officer, Owner, or Designee <br />Date <br />