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P/--- <br />r? <br />c ,. <br />ANNUAL FEE qanREPORT REQUEST _???'?? <br />PERMITTEE NAME: - William & Beverly Caldwell and Albert & Lola Nessellm N 12 2008 <br />Division u Neciamation, <br />PERMIT NO.: CM-1997-071 / :ning and Safety <br />OPERATION NAME: Caldwell-Nesselhuf Pit No.1 <br />ANNIVERSARY DATE: June 30, 2008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Crowley <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 vear'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 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: Albert F. Nesselhuf, Jr. <br />Permittee Name: William & Beverly Caldwell and Albert & Lola Nesselhuf <br />Address: 31738 Rd 13 <br />Manzanola, CO 81058 <br />Phone Number: (719) 462-5236 <br />Fax Number: (917) 254-3231 <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 />Signature of Corporate Office er, or Designee <br />Ze2' <br />Date