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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Ai- ; J.J/- <br />ANNUAL FEErand PORT REOUEST <br />' Elbert County <br />r'M-1988-101 <br />Fondis Pit <br />December 15, 2008 <br />J? <br />J <br />RECEIVED <br />1/DEC 16 2008 <br />Division of Reclamation, <br />/ i'/ Mining and afety <br />$$791.00 (Due on or before your anniversary date) <br />Elbert <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 <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 changes to the previous year's may are necessary, then no new map 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: Marilyn Sproch <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Elbert County <br />809 Ute Ave. <br />Simla, CO 80835 <br />(719) 541-2268 <br />(719) 541-2826 <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 <br />enclo <br />Si ature of Co orate O I er, or Designee <br />cw 1`10 <br />Date <br />M: \PERMIT?MASTERDOCUMENTS\M-AF-04