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A, ty?'JLS? <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 />Town of Crested Butte ?? <br />M-1981-002 -" <br />Mountain View Pit <br />July 15, 2009 <br />$323.00 (Due on or before your anniversary date) <br />Gunnison <br />Rms"D <br />JUN 2 2 2009 <br />Di*iaw of <br />Mix <br />9 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-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 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 durin the previous year and no <br />new chanizes 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: <br />Permittee Name: Town of Crested Butte <br />Address: 507 Marroon Ave. <br />P.O. Box 39 <br />Crested Butte, CO 81224 <br />Phone Number: (970) 349-5338 <br />Fax Number: (970) 349-6626 <br />:j?QJKN <br />_j 11 E., <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 />Signa orate Officer, Owner, or Designee <br />Date /_ - 9 - 2L O <br />M:IPERMITIMASTERDOCUMENTS\1\4-AF-04