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'f?p * Re-t- <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Chaffee County <br />PERMIT NO.: M-1978-192 <br />OPERATION NAME: Pit No 6 C P-3 <br />ANNIVERSARY DATE: June 30, 2008 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Chaffee <br />R ?IflE D <br />JUN 13 2008 c/ <br />Divisio" Q?.octajilation,nl , <br />Mining and Safety .// <br />According to-C'.R.S. 34-32:5-1-1-6-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 vour 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 vear's map are necessarv, 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 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: Joe Nelson <br />Permittee Name: Chaffee County <br />Address: <br />Phone Number: <br />P.O. Box 699 <br />Salida, CO 81201 <br />(719) 539-6961 <br />Fax Number: (719) 539-7442 <br />,OK <br />u"6?- 0 DES <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 />Sign tore of Corporate Officer.10wner, or Designee <br />Date <br />M: \PERMITIMASTERDOCUMENTS\M-AF-04