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r-✓vl W <br />✓ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />t/Cat Construction, Inc. <br />PERMIT NO.: <br />t/ M- 1982 -160 <br />OPERATION NAME: <br />Brighton Pit <br />ANNIVERSARY DATE: <br />November 30, 2006 <br />ANNUAL FEE DUE: <br />$688.00 (Due on or before your anniversary date) <br />COUNTY: <br />Weld <br />/0-/3 -o% <br />4-�OCT 10 2006 <br />Z/bivision 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 />- reclamation- ace -omplished- to-date- and - during- the- preceding-year,- new- d.sturbances -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 vear's map are necessary. then no new map is reouired. 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: James D. Felix <br />Permittee Name: Cat Construction, Inc. <br />Address: P.O. Box 257 <br />Westminster, CO 80036 <br />Phone Number: (303) 428 -9038 <br />Fax Number: (303) 427 -5023 <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 />Iiinature of Corporate Offi r, wner, or Designee <br />/✓)i /_._/7/ <br />Date <br />
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