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-6 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />Mineral County <br />"/M-1984-097 <br />Mineral County Pit <br />June 28, 2011 <br />RECEIVIG <br />JUN 13 2011 <br />PDivision et Reclamation, <br />R9ining and Safety <br />$791.00 (Due on or before your anniversary date) <br />Mineral <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 <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 your revised written annual report and annual report may to this form The Annual <br />Report & Fee requirement is not met until we have received the following components: fee. report, and <br />associated man. If no new disturbances or reclamation have occurred durin the previous year and no <br />new changes to the previous year's may 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: Leslie Cahill <br />Permittee Name: Mineral County <br />Address: P.O. Box 70 <br />Creede, CO 81130 <br />Phone Number: (719) 658-2360 <br />Fax Number: (719) 658-2931 <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 />Signature of C rporate Officer, Owner, or Designee <br />Date <br />MAPERMT WASTERDOCUMENTS\M-AF-04