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.. o~ <br />/~-~ ~~P~ RECEIVED <br />ANNUAL FE and REPORT REQUEST <br />AUG 0 ~ 2007 <br />D' ~sion of Reclamation, <br />PERMITTEE NAME: !Custer County Mining and Safety <br />PERMIT NO.: ~M-1995-026 <br />OPERATION NAME: Gravel Pit M-093 <br />ANNIVERSARY DATE: August 24, 2007 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Custer <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 submit the annual-fee, a report and map showing the extent of current 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 vour revised written annual report and annual report man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinc the previous year 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 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: Elinten-I~-Er~iekert pAd r D R ~' ~ ~o <br />Permittee Name: Custer County <br />Address: P.O. Box 1669 <br />Westcliffe, CO 81252 <br />Phone Number: (719) 783-2281 <br />Fax Number: (719) 783-0391 <br />If you have additional cormnents 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 />encl~d. <br />Signature of Corporate O ficer, Owner, or Designee <br />'7 /O-o7 <br />Date <br />M:~PERMIPMAS7ERD000MENTS~M-AF-04 <br />