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J~ <br />ANNUAL FEE and REPORT REQUEST <br />REGEIV,Ep <br />PERMITTEE NAME: Rio Blanco County <br />PERMIT NO.: M-2001-077 AUG 1 u 2001 <br />OPERATION NAME: Piceance Pit Division of naciamation, <br />Mining and Sa7ety <br />ANNIVERSARY DATE: August 28, 2007 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <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-showinb the-Pxtent -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 year, the dates for the beginning <br />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 map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that 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: David Morlan <br />Permittee Name: Rio Blanco County <br />Address: 570 Second St. <br />Meeker, CO 81641 <br />Phone Number: (970) 878-9590 <br />Fax Number: (970) 878-3396 <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 />~gnature of Corp at fficer, Owner, or Designee <br />7~0~0 7 <br />Date <br />