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M~ <br />.brvt,~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNtiAi. FF.F, and RF.PnRT RF. iO JEST <br />~/Fremont County <br />t/ M-1999-033 <br />Iioward Pit #1 & #2 <br />May 26, 2006 <br />//vAPR 16 Z~ <br />~tvbinn of Ib/neraltand GeWnyi. <br />$281.00 (Due on or before your anniversary date) <br />Fremont <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: sufimit_the=annual_fee,-a-reportand-map-showingahe-extent-of-current-disfurbsnces-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 />Ptease attach ym~r revised written anm~al report and anneal re nn rt ma~tathic farm- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pennittee Contact: Paul Garrett <br />Permittee Name: Fremont County <br />Address: 615 Macon Ave., Roam #105 <br /> Canon City, CO 81212 <br />Phone Number: (719) 942234 J <br />Fax Number: (719) 276-7321 <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 />Signature <br />Date <br />Owner, or Designee <br />M:~PERMI7IMASTERD000MENTSM-AF-04 <br />