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~.~..~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNiJAL FEE DUE„ <br />COUNTY: <br />6mk <br />~~~~ <br />ANNUAL FEE an REPORT REQUEST <br />Kit Carson County <br />~I-1989-003 <br />Raymond Schulte Pit <br />April 5, 2008 <br /> <br />~~'~~® <br />MAR 31 2008 <br />vision of a d Safety n, <br />Mining <br />$$791.00 (Due on or before your anniversary date) <br />Kit Carson <br />According to -C-R.S~-34=32-5-1"T6"or"C:R:S:-34=32-116; 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 upc~~ming 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 ~ZO new disturbances or reclamation have occurred during the previous year 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: ~ <br />Permittee Name: ]Kit Carson County <br />Address: 251 l~th St. ~ iy%~'.r~ d~ ~ <br /> <br />as/ l~~ ~r~, o/ <br />i~.o. Box i6o _ -- - _ _ - -- <br />]Burlington, CO 80807 <br />Phone Number: <br />Fax Number: <br />1;719) 346-8139 <br />1;719) 346-7242 <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 <br />enclosed. <br />n % / <br />Signature of Corporal:e Offic ,Owner, or Designee <br />Date <br />M:~PERMITIMASTERDOCUME'NTSV~f-AF-04 <br />