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- ~ ~,i.. <br />~~ ~- R~-r <br />ANNUAL FEE and REPORT REQUEST <br />-, <br />~, , <br />PERMITTEE NAME: The Regents of the University of Colorado ~ ~ ~~ ~ ~~® <br />PERMIT NO.: M-1981-302 / APR Y ~ 2008 v <br />OPERATION NAME: Deepe Farm Pit "-'~~~ <br />~ :,:~,ra~'.:ti~Cl~,1118t1Qn <br />ANNIVERSARY DATE: Apri120, 2008 ' end Safe1Y <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <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 during 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 S. Lipton <br />Permittee Name: The Regents of the University of Colorado <br />Address: 444 UCB <br />University of Colorado <br />Boulder, CO 80309-0444 <br />Phone Number: (303) 492-2222 <br />Fax Number: (303) 492-6448 <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 />Si a of orporat icer, caner, or Designee <br />Date <br />