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Feb 12 20 0H:40p <br />PERMIITEE NAME: <br />PERMIT NO.: <br />OPERA'T'ION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Ranch Land Rock Pit #2 <br />March 22, 2007 <br />$$688.00 (Due on or before your anniversary date) <br />Fremont <br />p.2 <br />R~ "Fly `~~ <br />'MAR 19 ~1~D1 <br />~v, <br />h`rinin , ~~ ~:aion, <br />' a'~a Safely <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 preceding year, new disturbances that aze anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the beginning <br />of active operations, and ttte date active operations ceased for the year, if any. <br />Please attach your revised written anppal report and annual report ntau to this form, The Annual Report <br />& Fee requirement is not met until we Lave received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous veer and no new changes to <br />the previous year's man are necessary, then no pew map is repaired, provided that the Operator shall state <br />this in the Annual Report. Please note shat an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the Following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: William Peetz <br />Pernittee Name: Ranch Land LLC <br />Address: 3925 HiH Circle <br />Colorado Springs, CO 80904 <br />Phone Number: (7l9) 492-0266 <br />Eax Number: (719) 473-5494 <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 s form along with your written report and map. Annuat Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />International Web Works <br />1-719-473-5494 <br />~ _ <br />!~ ~ % ~ <br />ANNUAL FEE and REPORT REQUEST <br />~ Rameh Land LLC <br />/M-2003-021 <br />3//a/o7 <br />Date <br />