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ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Ouray County RECEIVED <br />PERMIT NO.: M-1991-097 Aloe 0 1 <br />OPERATION NAME: Triple R Gravel Pit <br />ANNIVERSARY DATE: November 26, 2010,x.. n '=r gip{ <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116 each year,_on-the_anniversagAate_of,-tbe-permit-an- <br />operator shall submit the annual fee, a report and map showing the 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 ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated may. If no new disturbances or reclamation have occurred during the previous year and no <br />new chantyes to the previous vear's map are necessary, then no new map is required, 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: Chris Miller <br />Permittee Name: Ouray County <br />Address: P.O. Box 456 <br />Ridgway, CO 81432 <br />Phone Number: (970) 626-5391 <br />Fax Number: (970) 626-4439 <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 <br />enclosed. <br />CLovz AUL- <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />N 0 NFU co M: PERMITIMASTERDOCUMENTS\N4-AF-04 <br />