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.~ sy. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COCJN"IY: <br />A P ~ Rl~r <br />ANNUAL FEE and REPORT REQUEST <br />Montrose Cou ~" <br />M-1987-151 <br />Soderquist Pit <br />October 28, 2007 <br />REGEIVED~ <br />~~ ~ 9 Z00~ <br />Division of ReGamation, <br />Mining and Safety <br />$$323.00 (Due on or before your anniversary date) <br />Montrose <br />~7/G <br />~'~ According-to C.R.S. 34-32:5-1-16 or C-.R.S.-34-32-1.16, each yeaz,_on the_anniversary_ date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of cun•ent 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 far 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 moo to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated moo. If no new disturbances or reclamation have occurred during the arevious veer and no <br />new chances to the urevious year's man are necessarv,then no new moo is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may 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: Brian Wilson <br />Permittee Name: Montrose County <br />Address: 161 S. Townsend <br />Montrose, CO 81401 <br />Phone Number: (970) 252-7000 <br />Fax Number: (970) 252-7010 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i to this form along with your written report and map. Annual Report instructions are <br />~Cna ed. <br />' Signature of Corporate Officer, Owner, or Designee <br />~~~ ~~ <br />Date <br />M:~PERMIT411ASTERDOCUMENTSUi-AF-04 <br />