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<br />~F ~ ~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Rio Blanco Coun L~ <br />M-1999-040 <br />V <br />Red Wash Gravel Pit <br />May 17, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Rio Blanco <br />~~~6V~~ <br />MAY "~ 5 2008 `-~ <br />Division of r2eciamation, <br />Mining and Safety `.% <br />_Accordin_g to C.R.S. 34-32.5-116 or C_.R.S. 34-32-11_6, 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 upcoming 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 no new disturbances or reclamation have occurred durinE 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David P. Morlan <br />Permittee Name: Rio Blanco County <br />Address: 570 2nd St. <br /> Meeker, CO 81641 <br />Phone Number: (970) 878-9590 <br />Fax Number: (970) 878-3396 <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 />. ~ !~ <br />ignature of Corporate fficer, Owner, or Designee <br />~i/o 8 <br />Date <br />M:IPERMIT~MASTERDOCUMENTS~Iv1-AF-04 <br />