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r <br />AL FEE?an ORT R <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />-Ch rles W Houchin <br />1VI-1980-249 <br />Houchin Gravel Pit <br />February 4, 2010 <br />IV <br />? EIVED <br />?fAN 13 2010 <br />piviaijm of Reclamation, <br />$$323.00 (Due on or before your anniversary date) <br />El Paso <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 />_ <br />.reclamation accomplished-to-date and-during _thenreceding-year, resew disturbances that are-anticipated 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 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 year's may 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: Charles Houchin <br />Permittee Name: <br />Address <br />Phone Number: <br />Fax Number: <br />Charles W Houchin <br />P.O. Box 162 <br />Green Mountain Falls, CO 80819 <br />(719) 684-9285 <br />(715) 684-2695 <br />If you have additional comments and/or information that should be <br />below or is form al ith your written report and map. <br />Signa r orporate Officer, Owner, or Designee <br />007 'A <br />or CV6 <br />Date <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed.