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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />f / <br />d PORT REQUEST <br />AN AL FEE <br />Z rrles W Houchin <br />-1980-249 <br />Houchin Gravel Pit <br />February 4, 2011 <br />k?'? <br /> <br /> <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-t"ate 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 vour 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 may 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: Charles Houchin <br />V'I %---= vj I f--' F-0 -, <br />Permittee Name: Charles W Houchin <br />Address: P.O. Box 162 <br />Green Mountain Falls, CO 80919' <br />Phone Number: (719) 684-9285 <br />Fax Number: (715) 684-2695 <br />If you have additional comments and/or information <br />below or attaches tJiysX-e?ong with youry,?h, <br />tJ A\ NI 0 - 61- l.L PT' "e) U C-R 11`i- <br />, s_oNTpz,;F: iA0UG41A <br /> <br />00CA19 <br />-7 1 8 + - 41 7& 4o <br />-11 94- - zel 9 S <br />should be provided to the Division, please provide it <br />'and map. Annual Report instructions are enclosed. <br />Officer, Owner, or Designee <br /> <br />Date