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AN L FETE and REPORT REQUEST <br />PERMITTEE NAME: r' Otero County (Engineering) <br />PERMIT NO.: /M-1978-267 <br />OPERATION NAME: Argo Gravel Pit <br />ANNIVERSARY DATE: August 26, 2009 <br />or <br />ale. <br />RECeIVED <br />OTERO CU( .-?,, <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Otero <br />A-ccarding--to-.S. -S. 34-12.5-1.16_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 cuf entdisturtsarrces to-affeeted-- - <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 resort and annual resort man 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 man are necessarv. then no new man 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: Darryl Schulz <br />Permittee Name: Otero County (Engineering) <br />Address: P.O. Box 511 <br />La Junta, CO 81050 <br />Phone Number: (719) 383-3035 <br />Fax Number: (719) 383-3935 <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 />Signature Corpdfr'ate Officer, Owne'Designei <br />2 1-,;Fd 4 "?-? <br />Date V 10, <br />R&er'VE0 <br />JUL 3 <br />Division ? ?Q?9 <br />Of Declamation <br />Minin9 and Safety <br />M:\PERMII\ vMSTERDOCUMENTS\N4-AF-04