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<br /> ANNUAL FEt and REPORT REOUEST <br />PERMITTEE NAME: <br />PERMIT NO.: V1 ffrey L. Schumacher <br />" M-2006-072 <br />OPERATION NAME: Schumacher Pit #3 <br />ANNIVERSARY DATE: March 5, 2010 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Logan <br />IIECe?VlO <br />t?AR022010 <br />Div"n of Reclarnation, <br />4-0 Mining and Safety <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-ts-date-.anti-during-the-preceding-year; now-disturbances-that are. anticipated-to-occur- <br />during -- <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 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 vear'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: <br />Permittee Contact: Jeffrey L. Schumacher <br />Permittee Name: <br />Address <br />Phone Number: <br />Fax Number: <br />Jeffrey L. Schumacher <br />831 Park St <br />Sterling, CO 80751 <br />(970) 552-6979 <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 />Na .N;.,:..1 ae 4%v:l r {ve L Pf&'t. in. Z007. <br />i ature of Corporate Officer, Owner, or Designee #-?y 54;11 .Ohl 3 .. At[ s l?./d <br />131"03 iS tit wi? a.. ? _S?-4. //k„ <br />/- 2C / O .rf'-6 3 k&-L ,'66p111,.1, e S ?Zh h 3Uk -For over <br />Date A'N a S W A AA Gtr t t .?r?li??s? -.j,-, <br />3-1-icto