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AV) n'Zj' 14404 <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Noland Inc 14EMVED <br />PERMIT NO.: M-1994-108 MAR i / 2010 <br />OPERATION NAME: Cedar Point DWi0en of RecWma im, <br />ANNIVERSARY DATE: March 7, 2010 Aamn g aw ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) So* <br />COUNTY: Montezuma <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.- Teclamation-that`will'beperformed- durigtie"comingyear-U e3ates-for thi beginning <br />of - <br />active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report man 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 necessarv, 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: Rick Noland <br />Permittee Name: Noland Inc <br />Address: 40325 Hwy. 160 <br />PO Box 23 <br />Mancos, CO 81328-8976 <br />Phone Number: (970) 533-7774 <br />Fax Number: (970) 533-7099 <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 />Signatu of Corporate Officer, Owner, or Designee <br />qS11 3, 2C)/ Q <br />Date