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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANA FELT and PORT REQUEST <br />WD Witt Excavating <br />-1983-132 <br />Dewitt Excavating <br />ReCtIVED <br />/jU( 2 3 2010 <br />01 July 29, 2010 <br />$$323.00 (Due on or before your anniversary date) <br />Prowers <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 map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Phase note that an adequately labeled map that clearly delineates and includes the <br />gbove 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: Terry Dewitt <br />Permittee Name: DeWitt Excavating, <br />Address: 7395 U.S. Hwy. 50 W. <br />Lamar,-CO 81052 <br />Phone Number: (719) 336-4455 <br />Fax Number: (719) 336-8150 <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.