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;ze <br />PERMITTEE NAME: <br />PERMIT NO.: <br />T <br />Rivers Ranch Cattle Feeding LLC <br />1977-223 <br />RECEIVED <br />FEB 00 2010 <br />Division of RealaMejopn, <br />OPERATION NAME: Wiley Pit Mining ? Safety <br />ANNIVERSARY DATE: February 7, 2010 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Prowers <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 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 />m 1. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's map are necessary, then no new man 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: Tom McDonald <br />Permittee Name: Five Rivers Ranch Cattle Feeding LLC <br />Address: 3855 Precision Drive, Suite 160 <br />Loveland, CO 80538 <br />Phone Number: CF.PR.telephone_number <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it t this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate fficer, Owner, o Designee <br />l / as ?o o <br />Date