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~~l? ~ <br />PERMTITEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNIIAi, FF.F. and RF.PnRT RF.t1iiRST <br />~ Kiowa County <br />~ M-1991-078 <br />Peters Pit <br />February 4, 2006 <br />Ti ,-.. <br />:.'- ~~=~1l~D <br />FEB 0 2 2006 <br />~ivisian of Minerals and GppJp~Y <br />$281.00 (Due on or before your anniversary date) <br />Crowley <br />According to C,R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an t <br />operatp~>,aff ~„t,.,,;* tlre_annual_feer_a_reporLand_mapshowing_the_extenia£current_disturbances_to-affected <br />]and, reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated to I <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 far the year, if any. <br />Please attach ynnr revised written anneal re,Qnrt and anneal re~yQrt main 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 />Permittee Contact: Rick Spady <br />Permittee Name: Kiowa County <br />Address: P.O. Box 100 <br />Phone Number: <br />Fax Number: <br />Eads, CO 81036 <br />(719) 438-5810 - <br />(719)438-5327 <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 />tgna re of Cor rate O er, Owner, or Designee <br />Date <br />M:~PERMITNrASTERDOCUMENTSNr-AF-0O <br />