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PORT T REQUEST <br />AL FEE PndR-E <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />V/.S" h midt Construction Company <br />1-1983-035 <br />Vollmer Pit <br />May 12, 2010 <br />,'RECEIVED <br />APR 3 0 2010 <br />/'_ Division o? „eciianr?ation, <br />--i (J Mining and Safety <br />$$791.00 (Due on or before your anniversary date) <br />El Paso <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-accompl-ished-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 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 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: Scott Davis <br />Permittee Name: Schmidt Construction Company <br />Address: 2635 Delta Dr. <br />--- -C-olora o prmgs-CO-8D91-0-J----??? <br />Phone Number <br />Fax Number: <br />(719) 392-4207 <br />(719) 392-4245 <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 />Signature o Corporate Officer, Owner, or Designee <br />Date