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AC <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />M J Cadgene <br />M-1983-158 <br />. Cadgene Pit <br />RECEIvEID <br />./ FEB 0 $ 2010 <br />?j Division of Reclamation, <br />Mining & Safety <br />January 30, 2010 <br />$323.00 (Due on or before your anniversary date) <br />Montrose <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-disturbanc-es-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 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: , Ilqo (? <br />Permittee Contact: M. J. Cadene CH A? `? e 5 <br />Permittee Name: M J Cadgene <br />Address: P.O. Box 10 <br />Redvale, CO 81431 <br />Phone Number: (970) 327-4694 <br />Fax Number: (970) 327-4224 <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 />Signa of Corporat fficer, Owner, or Designee <br />Date