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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE~nd REPORT REQUEST <br />~N <br />Glenn E Sessions & Sons, Inc. ,/ <br />M-2003-058 -/ <br />Fairbanks Pit <br />December 4, 2007 <br />~"r~~Q®~ <br />DEC 0 3 X007 '/~ <br />~ivisio~r gar i~+~c~umanon, <br />Mining and Safety <br />$$323.00 (Due on or before your anniversary date) <br />Jackson <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 />_r_eclamation accomplished to date and during the preceding. year, new disturbances that are anti~ated 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 man to this form The Annual Report <br />& Fee requirement ~s not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during 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: -men ~-L'-r-S~sio,~ <br />~ Qsi_. ~ ~~~ ~ ~ <br />Permittee Name: Glenn E Sessions & Sons, Inc. <br />Address: <br />33492 Hwy 125 <br />P.O. Box 1076 <br />Walden, CO 80480 <br />Phone Number: (970) 723-4944 <br />Fax Number: (970) 723-8344 <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 />Signa re of Corporate O cer, Owner, or Designee <br />- ~ ~ `~Z~ <br />Date <br />}~ ~ ~-~~ M ~t 6~~ <br />\- ~,~~ , <br />