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,t,? *- R ev- <br />ANNUAL FEE and REPORT RE UEST <br />PERMITTEE NAME: Continental Divide Ranch, LLC <br />PERMIT NO.: M-2006-059 <br />OPERATION NAME: CDR Pit <br />ANNIVERSARY DATE: October 13, 2009 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Archuleta <br />Lam: '?V -J <br />gyp/ r,vi2..:? <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 />reclaroatiop aCGp ],ishe tQ Clate-and_dunng-the-precgding=mar, new-disturbanc-es t ar?nticipated t?occ_ ur <br />during the upcoming year; reclamation that W1-lPbe per of "rmed wing t ll' acoming-year, tTlie-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 vear's man are necessarv. then no new man is reauired. 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: Ron Trujillo <br />Permittee Name: <br />Divide Ranch, LLC <br />Continental <br />Address: ??j <br />A W4 Vq 01ki, &lolU4 <br /> Durango, CO 81301 <br />erv?a? ?1? r,a @5 o be-,, in-r forrn , n e?- <br />Phone Number: (970) *34AI 7 <br />Fp? 1?r. (OA *-961316 <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 />Signature of Corporate Officer, Owner, or Designee <br />W 3 /o <br />Date