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AF*.~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REP RT RE VEST <br />Weaselskin Corp. <br />M-1986-148 <br />Weaselskin <br />July 6, 2009 <br />IBC <br />~JUL ~ 8 2009 <br />~ / ~Ivisiai of Recl~~ow, <br />+'j~'y' Ming and Safety <br />$323.00 (Due on or before your anniversary date) <br />La Plata <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 />----=reclama ' 'shed-ta-date~d~~urmg--t ewer-b . -----_< ~~ <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <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 year's map are necessary, then no new. map is required, 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Douglas P. Thurston <br />Permittee Name: <br />Address <br />Weaselskin Corp. <br />12995 U.S. Hwy. 550 <br />Durango, CO 81303 <br />Phone Number: (970) 247-1691 <br />Fax Number: (970) 247-8120 <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 />S gnatur f Corporate Officer, Owner, or Designee <br />~ ^ C~9 <br />Date <br />