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<br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />" " )(?67- <br />ANN AL FEE and REPORT REOUEST <br />Baca County <br />?M-1978-225. <br />McVey Pit <br />CEBVED <br />MAR 2 3 2090 <br />?ivt I®? of <br />l ts?1?6 ? ip?, <br />!!?6n3n? ? ?? <br />April 28, 2010 <br />$$791.00 (Due on or before your anniversary date) <br />Baca <br />_ According.o 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 and map showing the `exterit 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: Troy Crane <br />Permittee Name: Baca County <br />Address <br />Phone Number: <br />Fax Number <br />741 Main St. <br />Springfield, CO 81073 <br />(719) 523-6532 <br />(719) 523-6584 <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 />.A <br />natu f Corporate Officer, Owner, or Designee <br />J 2Z-;2OId <br />Date <br />M:IPERMITIMASTERDOCUMENTS\M-AF-04