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~~ ~- QQT <br />ANNUAL FEE and REPORT REQUEST <br />ITTEE NAME: Cross Mountain Ranch Ltd. Partnershi <br />PERM _ / P <br />PERMIT NO.: M-1979-102 'v <br />OPERATION NAME: Kagie Gravel Pit <br />ANNIVERSARY DATE: June 21, 2008 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Routt <br />~~~~~~~ <br />MAY ~ ~ 2008 t,~ <br />~JiviS,or~ u: a~crpmation, ,~ <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, 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 vour 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 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: Bernard J. Petersen <br />Permittee Name: Cross Mountain Ranch Ltd. Partnership <br />Address: P.O. Box 897 <br />Craig, CO 81626-0897 <br />Phone Number: (970) 824-2803 <br />Fax Number: (970) 824-7081 <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 />/d 55 ~dltn fQ ~h /~dl~c~ ~L (/-~ ~Lfl~u6 ~Gu'~ <br />Signature of Corporate fficer, O ner, or Designee <br />~/~j~a <br />Date <br />