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?s <br />VIL) <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />F-and T Ri° r <br />ANN L FEE REPORT RE UEST <br />Yuma County <br />V'"1-1981-179 <br />Mekelburg Pit No 1 <br />June 30, 2009 <br />RECEIVED <br />AUN p 12009 <br />Division of Reclamation, <br /></V Mining and Safety <br />$$791.00 (Due on or before your anniversary date) <br />Yuma <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 currenf-disfurbances 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 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 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: Paul Like <br />Permittee Name: Yuma County <br />Address: <br />Phone Number: <br />Fax Number: <br />13 10 S. Blake St. <br />Wray, CO 80758 <br />(970) 332-5718 <br />(970) 332-3429 <br />110 (J.) urn. Mc,Gi n n i G <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 />enclos . <br />A# 111&_' <br />Signature of Corporate Officer, Owner, or Designee <br />S'- ?g -(9 <br />Date <br />M:IPERMITIMAS TERDOCUMENTSIM-AF-04