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rt2~ <br />~? <br />ANNITAT, FF.F. and REPORT RF.OTTF.ST <br />TEE NAME: <br />NO.: <br />'ION NAME: <br />RSARY DATE: <br />L FEE DUE: <br />/Grand County <br />v M-1995-004 <br />Inspiration Point <br />May 5, 2006 <br />RECEI'~ED <br />UAPR 2~ ~ <br />iviefoe of Mleerele e~ OeolopY <br />$688.00 (Due on or before your anniversary date) <br />Grand <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an <br />operaaor 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 ar_e_anticipated to__, __ _ <br />occur ~duting 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 />rh ynnr rPVised written anneal re~nrt and anneal rennrt ma=te this form. please note that an <br />labeled map that clearly delineates and includes the above elements may suffice for a written <br />records indicate the following permittee contact information. Please verify and make any necessary <br />Contact: Ken Haynes <br />Name: Grand County <br />467 E, Topaz Ave. <br />P.O. Box 9 <br />Granby, CO 80446 <br />Number: (970) 887-2123 - <br />Fax Number: (970) 887-3168 <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 <br />13 <br />Date <br />Owner, or Designee <br />