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g~ ~~ <br />/~ <br />(/ ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: i/ ~tio Blanco County <br />PERMIT NO.: l~/ M-2001-077 <br />OPERATION NAME: Piceance Pit <br />ANNPJERSARY DATE: August 28, 2006 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <br />RECEIVED <br />~`~AUG 17 ?p06 <br />Division of Reclamation, <br />Mining and Safety <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />_ __ shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the precedin'g~year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be perfonned during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />map (All are required regardless of the level of disturbance or absence of disturbance during the previous <br />year). Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: <br />Permittee Name: <br />Address: <br />~~ <br />Rio Blanco County <br />570 Second St. <br />Meeker, CO 81641 <br />~~,JiIJ V~lorl~ir- <br />v <br />Phone Number: (97A}8~8-550'L ~t~o -82$ - 95~ 0 <br />Fax Number: ~Zo - $Y/~- 3'J `tf~ <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 enclosed. <br />/~~.~._~ <br />ignature of Corporate Officer, Owner, or Designee <br />7~/~ ~ <br />Date <br />