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AAINCIAf, FEE and~~ PORT QUEST <br />PfiRMITTEE NAME' ~/ Bent County <br />PERMIT NO.: l/ -2804-057 <br />OPERATION NAME: Reyher Trusts Pit <br />ANNIVERSARY DATE: January 27, 2067 <br />ANNUAL FEE DUE: $$688.06 (Due on or before yopr anniversary date) <br />COUNTX: Bent <br />RECEIVED <br />~ JUN .112007 <br />of Redametion, <br />~ '""nm9 and Safely <br />According to C.RS. 3432.5-116 or C.RS. 34-32-1.16, each yeaz, 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 accomplts6ed to date and during the preceding year, new disturbances that are amicipated to <br />occur during the upcoming year, reclamation that will be performed during the contiog 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 annnal report and anneal report map to this form. The Annual <br />Report & Fee requirement is not met antil we have received the following rnmponents: feed Dort, and <br />associated man. If no new disturbances or reclamation have occurred durinE the previous veer and no <br />Operator shall state this in the. Apnpal Report. Please note that an adequately labeled map That clearly <br />delineates and includes the above elements may suffice for a written report. <br />Aivision records indicate the following permittee contact informatioo. Please verify and make any necessary <br />changes: <br />Permittee Contact: Crary L. Pritchard <br />Pet'mittee Name: <br />Address: <br />Bent County <br />725 Bent Ave <br />P.O. Hox 350 <br />Las Animas, CO $1054-0350 <br />Phone Number: (719) 456-2223 <br />Fax Number: (719) 456-0375 <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. C` <br />Designee <br />pace <br />M -Ar-01 <br />z00 9£6'ON L~~T~ LOiSSi90 <br />