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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />A AZ FE and REPORT REQUEST <br />Schuler Terracing <br />V/M' -1995-095 <br />Simla Highway Pit <br />July 8, 2010 <br />Ifl <br />r?? <br />?9CEIVE, D <br />JUN 3 0 ZoIjU <br />$$323.00 (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 accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />--during the upcomirt; year; reclamation-that will-be-per:"ormed during t1he-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: Henry A. Schuler <br />Permittee Name: Schuler Terraci g ... j <br />%L-0-- p ,-.` _ <br />Address: 510 Caribou St. 10-1 <br />P.O. Box 398 + ? <br />Simla,-CO 80835 - -- t <br />Phone Number: (719) 541-2396 & ,t j °7 C 9 2 ?,P -0,277- <br />Fax Number: (719) 764-2659 "J it -- l N/ I - y3 <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 orporate Officer, Owner, or Designee <br />'-- b__L -- ? 9 7 rJ <br />Date