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IN <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />6- <br />ANNUAL FEE and REPORT REOUEST <br />vli <br />Pathfinder Development, Inc. <br />M-1994-113 <br />Pathfinder Pit <br />October 4, 2009 <br />RL2'13"IvVE-D <br /> <br /> <br />$791.00 (Due on or before your anniversary date) <br />San Miguel <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 />-reclamation accomplished to date--and- during the preceding year, -new-disturbances-that are- anticipated-to-ecEUr - <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 man 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 maiD 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 perinittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact:. delm Deurler-- <br />Permittee Name: Pathfinder Development, Inc. <br />Phillip F. Woodard <br />Pathfinder Development, Inc. <br />Address: P-?f -1-n-x- 3332 5502 Cypress Ct. <br />Telluride, O 84433_ _ Midland. TX 79707 <br />Phone Number: -(9:70)-:728 016:7 432-697-8440 <br />Fax Number: -(4'18):28-4463 <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 />Oct. 19', 2009 <br />Date