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.j?Ltovr <br />ANNUAL FEE and REPORT REOUEST ReCiio <br /> <br />PERMITTEE NAME: LBCR, LLC i? AUG y <br />200 <br />9 <br />PERMIT NO.: M-1992-054 ? Divigi <br />' <br />" <br />a <br />OPERATION NAME: Ignacio Pit Ring <br />nd Ste, ty °n <br />ANNIVERSARY DATE: July 14, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: 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 />-Iamkt&rr-ac`co i d-o-dlaffe""an urmg a preceding year, new is r ances a are anu pa a to occur <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 vour revised written annual report and annual report may 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 vear's map are necessary, then no new may 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 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: Todd Fisher <br />Permittee Name: LBCR, LLC <br />Address: 1440 Blue Sage Ct. <br />Boulder, CO 80305 <br />Phone Number: (303) 499-0707 <br />Fax Number: (303) 554-0724 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attac it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Date / I I ) <br />- Ze? A 7,--n _;?? <br />S' re of orporate Officer, Owner, or Designee <br />2111-169