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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT RE UEST <br />Vista Verde Village, C. <br />M-1992-049 <br />Peck Pit <br />July 13, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Ouray <br />JAN 0 2Z009 ? <br />Division u? 'd"j q, <br />and -U* <br />M0 <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 i1rin recesi ng_X,gar 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 e`gtnntng <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 necessarv, then no new map is reauired. 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: Keith Zimmerman <br />Permittee Name: Vista Verde Village, LLC. <br />Address: 17449 Hwy 550 <br />Ridgway, CO 81432 <br />Phone Number: (970) 325-0068 <br />Fax Number: <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 />of Copoorate Officer, Owner, or Designee <br />2 <br />Date <br />pcv" <br />u N l? <br />cr?d/? i- •? 711 <br />a / <br />e /1 <br />