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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />.~ ~ ` R~°T <br />ANNUAL FEE and REPORT REQUEST <br />~/-Rude Inc <br />~/M-1989-009 <br />J-Rude Inc <br />March 17, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Prowers <br />R~c~,v~® <br />~1AR 17 2008 <br />Di slop of reclamation, <br />Mining and 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 />-- -- reclamatio-raceomplished--to date--and during-thy-preceding-year,-new-disturbances ~ ~~ a :.,~~atcrl ta-o~t~--------°~ <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 vour revised written annual report and annual report man to this form The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred during the previous vear and no new changes to <br />the previous year's man 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Rudy Torres <br />Permittee Name: J-Rude Inc <br />Address: 1750 CR HH <br />Lamar, CO 81052 <br />Phone Number: (719) 336-7361 <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 />Sign of ~ orate Officer, Owner, or Designee <br />~f ~~jo~ <br />Date <br />