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6 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~~ ~~ ~ <br />ANNUAL FEE and REPORT REQUEST <br />Colorado Division of Highways <br />M-1979-155 <br />Dotsero Cinder Pit <br />February 1, 2008 <br />RG~i~I~E® ' / <br />MAR 2 4 2008 V ~0 <br />Division of Reclamation, , <br />Mining and Safety <br />$$323.00 (Due on or before your anniversary date) <br />Eagle <br />According to C.R.S. 34-32.5--116 or C.R.S. 34-32-1.16, each year, on the 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 durin the previous vear 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: Jason Smith <br />Permittee Name: Colorado Division of Highways <br />Address: 222 S 6th St Rm 317 <br />Grand Junction, CO 81501 <br />Phone Number: (970) 248-7239 ~ 9TH) ~~3 - ~~, <br />Fax Number: (970) 248-7292 ~~7v) ~~ 3 - ~`22 ~ <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 Annual Report instructions are <br />enclosed. <br />Si ature of Corporate Officer, Owner, or Designee U r~/JS ~ ~~o~'€D fN '2Q~1~ <br />~~ ~y ~~ <br />Date <br />M:~PERMI TVvIASTERDOCUM ENTSVvi-AF-04 <br />