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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and(RE OR REQUEST <br />P;uebIo County <br />-1997-081 <br />Everhart Pit <br />March 3, 2010 <br />biv k- <br /> <br />rRO 2 2010 <br />Division of RecWmabp, <br />Wing and Safety <br />,IV $$791.00 (Due on or before your anniversary date) <br />Pueblo <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 <br />operator shall submit the annual fee, a report acid map showing the extent of current disturbances to affected" <br />' land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: Patricia K. Coffee <br />Permittee Name: Pueblo County <br />Address: 33601 United Ave <br />Phone Number: <br />Pueblo, CO 81001 <br />(719) 583-4723 <br />Fax Number: (719) 583-4944 <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 <br />enclosed. <br />Signature of Corporate Officer, O , or Designee <br />Date <br />M:IPERMITU?IAS TERDOCUMENTS\M-AF-04