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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />f <br />AN UAL FEE and PORT REQUEST <br />Las Animas County <br />M-2000-053 <br />Castillo Pit <br />June 12, 2008 <br />J le <br />Aej <br />JUN 0 2 24.0,8 <br />?tSlblp .C}i s?et?Cictftgn, <br />?st?R;?m9,and?? <br />$$791.00 (Due on or before your anniversary date) <br />Las Animas <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 vour 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 may. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous vear's map are necessarv, 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 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: Phil Dorenkamp <br />Permittee Name: Las Animas County <br />Address: 2000 N. Linden Ave. <br />Trinidad, CO 81082 <br />Phone Number: (719) 846-2931 <br />Fax Number: (719) 846-0434 <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 />enclose I "?? / <br />Officer, Own,pf, or Designee <br />Date <br />M:\PERMIT\MASTERDOCUMENTS\M-AF-04