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O? <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />Ahe Fort Lyon Canal Company <br />zM-2001-097 <br />Fort Lyon - State Pit No. 1 <br />October 8, 2008 <br /> <br />SEP <br />Division or reclamation, <br />.fin Mining and Safati <br />$$791.00 (Due on or before your anniversary date) <br />Bent <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 accomp-lishee-d-to--date an during tFe preceding year, new i_s1&Fances 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 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: Manuel Torrez <br />Permittee Name: <br />Address <br />Phone Number: <br />The Fort Lyon Canal Company J N C) LkN N 4. i; 5 " <br />750 Bent Ave. <br />Las Animas, CO 81054 <br />(719) 456-0720 <br />Fax Number: (719) 456-1609 <br />i Ln?i??L ??tPfrtt ??rJ <br />1-?Si yarL byr s?? r hU5 --- <br />tv a ? ? a UL n. 5t [? . <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 Co orate Of i er, Owner, or Designee <br />C? \Q`Q& <br />Date