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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />kTamrock Gravel Company <br />i,<1-2001-068 <br />Bottomless Pit <br />September 17, 2008 <br />o•11-1-1 <br /> <br />4AEP 0 8 2008 <br />?idtaioo Of ReclaaiM ation, <br />Mi:r ng and SaLaly <br />$$791.00 (Due on or before your anniversary date) <br />Las Animas <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 your 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 year'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: Brent Tamburelli <br />Permittee Name <br />Address: <br />Phone Number: <br />Fax Number: <br />Tamrock Gravel Company <br />137 Plum Street <br />Trinidad, CO 81082 <br />(719) 846-3034 <br />(719) 846-7842 <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 wit our written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />=3-0cf <br />Date