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Re6 - 4-io A IF= - RPM' <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />'Colorado Department of Transportation <br />M-1996-007 <br />Spring Creek Pass <br />May 2, 2010 <br />"scovo <br />.,/ APR 2 01?w1io?ao <br />won ©i A irmc <br />and SsIetY <br />$791.00 (Due on or before your anniversary date) <br />Hinsdale <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 an-d-inap showing the extent-of currenf -d isturbarices td 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 vour revised written annual resort and annual report man 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 chanEes to the previous vear's map are necessarv. then no new man is reauired, 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: Jason Smith <br />Permittee Name: Colorado Department of Transportation <br />Address: 222 S 6th St Rm 317 <br />Grand Junction, CO 81501 <br />Phone Number: (970) 683-6223 <br />Fax Number: (970) 683-6227 <br />If you have additional comments and/or information that shoul <br />below or attach it to this form along with your written rep, <br />enclosed. <br />Signatufe of C0,116orate Officer, Owner, or Designee <br />Date <br />l??t d- av? <br /> <br />v t6-Y1 S. <br />t <br />e <br />M:\PERM TU%4ASTERDOCUMENTS\M-AF-04