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O.C 4, Qom' <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Montrose County <br />PERMIT NO.: M-1983-208 c? <br />OPERATION NAME: Shavano Pit <br />ANNIVERSARY DATE: March 7, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <br />EC IF R:IF <br />? <br />FED 1' 62009 <br />Division of Reciarnation, <br />Mining and Safety <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 distui aaR s o 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 map 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_ map are necessary, then no new map is reauired. 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: Brian W. Wilson <br />Permittee Name: Montrose County <br />Address: 161 S Townsend Ave <br />Phone Number: <br />Fax Number: <br />Montrose, CO 81401 <br />(970) 252-7000 <br />(970) 252-7010 <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 orm <br />along with your written report and map. Annual Report instructions are <br />l <br />t <br />Za . <br />e e o f Corporate Officer, Owner, or Designee <br />Date <br />M:\PERMIT\MASTERDOCUMENTS\M-AF-04