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I <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />R (2 4- PN-r <br />ANNUAL FEE and REPORT REOUEST <br />XTO Energy Inc. <br />M-2000-073 <br />Shults Gravel Pit <br />June 27, 2008 <br />$$0.00 (Due on or before your anniversary date) <br />Rio Blanco <br />RE <br />:JUN 19 2008 <br />Division of Kaciarnation, <br />Alining and Safety I.-P <br />-According to_C.R.S._34-32.5-L1.6_or C.R.S. 34-32-1.16, 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 man 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 chanEes 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: Kelly Small <br />Permittee Name: XTO Energy Inc. <br />Address: 2700 Farmington Ave K #1 <br /> <br />Farmington, NM 87401 A-L t PAC t) yyl 2 9 4 <br />Phone Number: (505) 564-6708 505 - 333- 3 1 L A5 <br />Fax Number: n b 5- A 1 ?)- O 5A W <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or a it to this form along with your written report and map. Annual Report instructions are <br />enclose X <br />Signature of Corporate Officer, O n , or Designee <br />Date <br />M:IPERMITIMASTERDOCUMENTSUvI-AF-04