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ol< <br />P <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br /> <br />41. <br />ncoln County <br />C & D Farms No. 2 <br />May 11, 2010 <br />ANNUAL FEE DUE: $$323.00 (Due on or <br />COUNTY: Lincoln <br />Lv J?i?????D <br />J kQh MWI PV <br />your anniversary date) <br />According to_C.R.S. 34-32.5=11.6-or-C.R.S.=34-32-1-1-6; each-ye r-,-on-the-anniversary-date-of the permit,--ari -- -- <br />operator shall submit the annual fee, a report and map showing he extent 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 ceas d for the year, if any. <br />Please attach your revisea written annual report anu anal <br />Report & Fee requirement is not met until we have received <br />associated map. If no new disturbances or reclamation have <br />new changes to the previous year's map are necessary, then <br />Operator shall state this in the Annual Report. Please not <br />delineates and includes the above elements may suffice for a writ <br />Division records indicate the following permittee contact <br />changes: <br />Permittee Contact: Kenneth Morrison <br />Permittee Name: Lincoln County <br />Address: P.O. Box 39 <br />Hugo, CO 80821 <br />Phone Number: (719) 743-2337 <br />Fax Number: (719) 743-2815 <br />If you have additional comments and/or information that should <br />below or attach it to this form along with your written repor <br />enclosed. <br />Sig ature of Corporate Officer, Owner, or Designee <br />-4r/ 0 -2 <br />Dale <br />eport map to this form. The Annual <br />following components: fee, report, and <br />erred durinu the nrevious vear and no <br />that an adequately labeled map that clearly <br />n report. <br />Please verify and make any necessary <br />provided to the Division, please provide it <br />and map. Annual Report instructions are <br />M:\PEPMITU 4ASTERD000NMNTSUM-AF-04