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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Bridal veil Construction <br />PERMIT NO.: M-2001-054 <br />R!q-- F.gvn?rr' <br />OCT 2 712o0j ? <br />OPERATION NAME: Bridalveil DNISt0A1 , c;amafiion, <br />AR;ning and ?cfety <br />ANNIVERSARY DATE: October 28, 2007 <br />ANNUAL FEE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Ouray <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 man showing the extent of current disturbances to affect land, reclamation <br />accomplished to date and during the proceding year, new disturbances that are anticipated to occur during the <br />upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active <br />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 may. <br />If no new disturbances or reclamation have occurred during the previous year and no new chan1jes to the <br />previous year's map are necessarv, then no new map is required, provided that the Operator shall state this <br />in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above <br />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: <br />Permittee Name: <br />Address <br />Phone Number: <br />FAX Number: <br />Emery L. Olin <br />Bridalveil Construction <br />1796 N. Main St. <br />PO Box 1412 <br />Ouray, CO 81427 <br />(970)325-4674 <br />L? <br />If you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signatu& of orporate Officer, Owner, or Designee <br />?d fL?/r> <br />Date/