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RV '?'_ R-r <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />7M M J Cadgene <br />M-1983-158 <br />Cadgene Pit <br />January 30, 2011 <br /> <br />V/ QEC J u LiJ I0 <br />Divis'lon of Reclamation, <br />n., Fe+. <br />$323.00 (Due on or before your anniversary date) <br />Montrose <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 may 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 chanEes 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: M. J. Cadgene <br />Permittee Name: <br />Address: <br />M J Cadgene <br />P.O. Box 10 <br />Redvale, CO 81431 <br />Phone Number: (970) 327-4694 <br />Fax Number: (970) 327-4224 <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 />- ?A) ", L) fz (? <br />Signa e f Corpora Officer, Owner, or Designee <br />/ p U <br />Date