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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ar- k???F <br />ANNUAL FEE and REPORT REOUEST <br />Rio Grande Ranch, LLC <br />M-2004-045 <br />Hanna Pit No. 1 <br />March 28, 2010 <br />$323.00 (Due on or before your anniversary date) <br />Rio Grande <br /> <br />MAR 29 2010 <br />©iv*On Gt FtsGiasn?aa. <br />Mining and 51" <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 />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's may 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 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: Kevin W. Ames <br />Permittee Name: Rio Grande Ranch, LLC <br />Address: P.O. Box 880 <br />South Fork, CO 81154 <br />Phone Number: (719) 657-0261 <br />Fax Number: (719) 657-0372 <br />(719) 873-1012 <br />(719) 873-1058 <br />If you have a i onal comments and/or information that should be provided to the Division, please provide it <br />below or a to thj#,& i along with your written report and map. Annual Report instructions are enclosed. <br />Sigr}hture of Co*(orate fficer, Owner, or Designee <br />Date