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<br />As 4- 0i <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 />Rio Blanco County <br />M-2002-049 ./ <br />Quinn Draw Gravel Pit <br />May 8, 2009 <br />$323.00 (Due on or before your anniversary date) <br />Rio Blanco <br />CEtV 0 <br />,/ MAY 1 J 2009 <br />Division of HSec,-matioa, <br />t% Mining and Safety <br />_? <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 vour revised written annual report and annual report may 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 vear's map are necessary, then no new may 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: David P. Morlan <br />Permittee Name: Rio Blanco County <br />Address: 570 2nd St. <br />Meeker, CO 81641 <br />Phone Number: <br />Fax Number: <br />(970) 878-9590 <br />(970) 878-3396 <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 />enclosed. <br />S' ature of Corpo e fficer, Owner, or Designee <br />?{ - as o9 <br />Date <br />M:\PERMIT\MASTERDOCUMENTS\M-AF-04