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~. <br />~~ ~- Q ~ <br />ANNUAL FEE and REPORT REQUEST ~ ~ ~ ~~ <br />PERMITTEE NAME: Russell Ranch General Partnership l/ ~PR 2 9 <br />/ 2008 ~ <br />PERMIT NO.: M-2006-008 l/ 9iboai~,~~ c~ i,~~;c'~mation, <br />OPERATION NAME: Russell Ranch Pit iiflining ar:~ Safety <br />ANNIVERSARY DATE: Apri127, 2008 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <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-ycar~ reclamation-that-w-i~ll-be-performed=during the -coming year; the-da~s -for-the-beginiiing -- -- -~ <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 chanties 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: Rog r~ ~~~ ~°~~-~"~ <br /> <br />Permittee Name: Russell Ranch General Partnership <br />Address: 1240 Rio Blanco County Road 8 <br /> P.O. Box 597 <br /> Meeker, CO 81641 <br />Phone Number: (970) 878-4810 <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 />~~ ~ <br />Signature of Corp Officer, Owner, or Designee <br />~ ~~' ~~,' <br />Date <br />s~.f~ ~~~ <br />`17a-3~~ -7,3~ <br />