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CSC <br />PERMITT]EE NAME: <br />PERMIT 1\f0.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />/~=~Pr <br />ANNUAL FEE and REPORT REQUEST <br />~~~~~ <br />~0l~ 3 0 2007 <br />~' ision of ~eciamation, <br />d~ Mining and Safety <br />Logan County <br />~1VI-1987-159 <br />Guenzi S & G Pit <br />December 28, 2007 <br />$$791.00 (Due on or before your anniversary date) <br />Logan <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />___ operator sha_ll_submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that'are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please att:~ch your revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator :shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ~ ~ • S ~eti ^ ;,^q a-o,n <br />Permittee Name: Logan County <br />Address: 315 Main St., Ste. 2 <br />Sterling, CO 80751 <br />Phone Nurriber: -(~-';z9~-5z~-2.6$$S-~ q ~- O 5 Z Z, - "~ a <br />Fax Number: (970) 522-4018 <br />If you have- additional comments and/or information that should be provided to the Division, please provide it <br />below or a. h It this form along with your written report and map. Annual Report instructions are <br />enclosed. i~~ // <br />~N~~ ~ <br />Date <br />M:~PERMITIMASTERDOC UMENTS~Iv1-AF-04 <br />Signa re of rporate Offic caner, or Designee <br />o <br />