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pa +- 01 <br />ANNUAL FEE and REPORT REQUEST RECEIVED <br />PERMITTEE NAME: Stone Cliff Investments, LLC <br />PERMIT NO.: M-2003-002 AUG 2 5 ?noq <br />OPERATION NAME: Ghost River Gravel Pit ? Division of m(-c,amation, <br />Mining and Safety <br />ANNIVERSARY DATE: August 11, 2009 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Huerfano <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 />_ - re,Oamation_accomplished-to-date-and-during-the-preceding-year,--ne v-disturbances-that-are-aiy&-ipated-t 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 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 />man. 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 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: Steve Melvick <br />Permittee Name: Stone Cliff Investments, LLC <br />Address: 255DQ 4e <br />,-Waodimrd Park, 60 80863 <br />Phone Number: <br />Fax Number: - <br />3a4 Dj-, wls/olj RD. <br />VI 1AL4A K-11 ?f3flS <br /> <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 />Officer, Owner, or Designee <br />C?Y.z,.o9 <br />Date