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~~ <br /> ~/ f/\ / / <br /> AL FEE and REPORT REQUEST <br />PERMITTEE NAME: /Rick Ensminger <br />PERMIT NO.: ~M-2002-068 <br />OPERATION NAME: Ensminger Pit <br /> <br />ANNP/ERSARY DATE: p~~ <br />July 29, zoo7~~z3 ~" ~` `~ <br />ANNUAL FEE DUE: $$~i:f(0 (Due on or before your anniversary date) <br />COUNTY: Phillips <br />R~~~ R ~4 ~® <br />vJUL 2 0 2007 <br />Division of Reclamation, <br />,CinFng and SafotY <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 sub t t e _annumg,~~eport~tldlnap_sho~ving_Iha_extent_oLcurrent_disturbances_to_ affected .land, _ <br />reclamation accomplished to date and during the preceding year, new disturbances that are 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 vour 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 durinti the previous vear and no new chanties to <br />the previous year's map are necessary, then no new man 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 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: Rick Ensminger <br />Permittee Name: Rick Ensminger <br />Address: 3500 Hwy. 6 <br />Box 276 <br />-' Haxtun, CO 80731 -~ <br />Phone Number: (970) 774-6108 <br />Fax Number: (470) 774-6133 <br />-- - --- -^ <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 />,._~a.....-_..__~ - ~... <br />~A - <br />Signatu~ie of Corporate Officer, Owgl f, or Designee <br />Date <br />