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III IIIIIIIIIIIII III <br /> ANNUAL FEE and REPORT REOUEST 999 <br /> RECEIVED <br /> MAY 18 2001 <br /> PERMITTEE NAME: Chaffee County Division of Minerals and Geology <br /> PERMIT NO.: M-1985-091 <br /> OPERATION NAME: Salida Pit <br /> ANNIVERSARY DATE: June 30,2001 <br /> ANNUAL FEE DUE: $550.00 (Due on or before your anniversary date) <br /> COUNTY: Chaffee <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 map to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Perm ittee Contact: Cheri Moore <br /> Perm ittee Name: Chaffee County <br /> Address: P.O. Box 699 <br /> Salida, CO 81201 <br /> Phone Number: (719) 539-6961 <br /> Fax Number: (719) 539-7442 <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 /> Sign u e 6 Corporate Officer or Owner <br /> .a -11 - Ot <br /> Date <br /> M TERMITMASTERDOCUbfENTSIM-Ar-OS <br />