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n -- <br />M <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />A-C 7 <br />ANNUAL E11nd P RT LOITFST <br />._ Kit Carson County <br />`-'M-1982-098 <br />Beattie Pit #1 <br />June 24, 2008 <br />RFCr=jVE0 <br />- % 2 7 2008 <br />49'Mi n and Safety n. <br />;Wing a <br />$$323.00 (Due on or before your anniversary date) <br />Kit Carson <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 <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 during the previous year and no <br />new changes to the previous year's may are necessary, then no new may 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 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: Carol Fritz <br />Permittee Name: Kit Carson County <br />Address: P.O. Box 160 <br />Burlington, CO 80807 <br />Phone Number: <br />Fax Number: <br />(719) 346-8139 <br />(719) 346-7242 <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 />en sed. 1__7 <br />Signatur of Co orate Of r, Owner, or Designee <br />Date <br />M:\PERMITIMASTERDOCUMENTS\M-AF-04