2008-05-27_REPORT - M1982054

• Permit No: M1982054
• IBM Index Class Name: REPORT
• Doc Date: 5/27/2008
• Doc Name: Annual Fee/Report/Map
• From: Kit Carson County
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: BMK
• Media Type: D
• Archive: No

bPERMITTEE NAME:

PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
-Kiit Carson County
e--M-1982-054
Eberhart Pit
June 24, 2008
RECEIVED
MAY 2 7 2008
_Rvision of Reclamation,
Mining and Safety
$$791.00 (Due on or before your anniversary date)
Kit Carson
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 shall sub-rhit the annual fee, a report and map-showing the-extent -of- current disturbances-to affected.
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated may. If no new disturbances or reclamation have occurred during the previous -year and no
new changes to the previous year's map are necessarv, then no new map is reauired, provided that the
Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly
delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Carol Fritz
Permittee Name: Kit Carson County
Address: P.O. Box 160
Burlington, CO 80807
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
0"_('Cs( \
Signature o Corpor to Officer, D*ner, or Designee
Date
ANNUAL FEE and REPORT REOUEST
M:\PERMIT\MASTERDOCUMENTSUAI-AF-04