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~~ ~P~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~ Rio Blanco County <br />:/~I-1999-040 <br />Red Wash Gravel Pit <br />May 17, 2007 <br />N~ <br />~~~r-~~r~lD <br />~, .., ~ ~ zoos <br />Dlvl-.!~ ~r ~. ~ .lun. <br />~Ii illy, ~..~.i; ti:~ <br />$$281.00 (Due on or before your anniversary date) <br />Rio Blanco <br />- - -- Acc-0rding r~ r R_S._34,3~.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 ofcurrent 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 maa to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, resort, and <br />associated maa. If no new disturbances or reclamation have occurred durinc the previous veer and no <br />new chances to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Reuort. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David P. Morlan <br />Permittee Name: Rio Blanco County <br />Address: 570 2nd St. <br /> Meeker, CO 81641 <br />Phone Number: (970) 878-9590 <br />Fax Number: (970) 878-3396 <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 />~~_ <br />~SSgnature of Cor~or2le Officer, Owner, or Designee <br />/ .s-/,~ ~ <br />Date <br />M:~PERMITVv1ASTERD000MENTSUI-AF-04 <br />