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<br />_, <br />~. <br />I <br />' ~ ~ , V <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Fremont County <br />~14I-1999-033 <br />Howard Pit #1 & #2 <br />6~/~ <br />f~a~G ~9 <br />MAY 1 ~ 2008 <br />/Dig-sta-I u- r~eG:~r~ation, <br />A9inin~ and ~agety <br />May 26, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Fremont <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 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 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 attach your revised written annual report and annual report man 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 durinE the previous year and no <br />new changes to the previous year's man are necessary, then no new man is reauired, 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 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: Paul Garrett <br />Permittee Name: Fremont County <br />Address: 615 Macon Ave., Rm. 105 <br />Canon City, CO 81212 <br />Phone Number: (719) 942-4234 <br />- ~. <br />Fax Number: (719) 276-7321 <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 />enclosed. <br />Signature of <br />Date <br />Owner, or Designee <br />v,~ <br />M:~PERMITIMASTERDOCLTMENTSUvi-AF-04 <br />