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o,~ <br />~,n <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~ ` <br />ANNUAL FEE an REPORT REQUEST <br />~ Frank Laughrey <br />~VI-1991-082 <br />Tiger Timber Site <br />March 17, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Teller <br />~~~~~[~~ <br />APR 2 8 ZOC.~ <br />ivision o7 r~eciamation, <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 accomplished-to--date-and-during the-preceding year,-nesv 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 />man. 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: Frank Laughrey <br />Permittee Name: Frank Laughrey <br />Address: P.O. Box 128 <br />Lake George, CO 80827 <br />Phone Number: (719) 748-3621 <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 Corporate Officer, Owner, or Designee <br />25:e8 <br />Date <br />j?/',e. Piave ~~ iy r'emaveel ZdS3 euL.e ~arJS <br />o~gvHa~er~a1 tti~s Past y~~r. 7/e ed.~~a4r <br />o ~' t! e Pr z' has a /~ u yod t/e ~p /, ~~1~ . <br /> <br />