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w <br />02/18/2009 08:23 FAX 7194735494 RANCHLAND <br />A1?1N1VAL FLEE d4 REOU EST <br />nch Land LLC <br />PERMITTEE NAME: X-2003-021 <br />PERMIT NO.. OPERATION NAM Pt Ranch Land Rode Pit 002 <br />ANNIVERSARY DATE: March 22, 2009 <br />ANNUAL FEE DU : $5791.00 (Due on or before your annivcrsarv date) <br />COUNTY: Fremont <br />2002 <br />DlL <br />k- <br />RECEWED <br />AR 2 0 2009 <br />Division of Reclamation, <br />-fo l#rfitwing and Safety <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent or current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances tliat are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the comihl; year, the datc3 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 />Fcr requirement is not met until we have received the following components: f report, and associated <br />map. if no new disturbances or reclamation have occurred during the previous Year and no new changes to <br />'ear's man are necessary, then no new may is renuired provided that the Operator shall state <br />i46 in die Annual Report. Please note that an adequately labeled map that clearly delineates and includes they <br />acove eiements may suf]tce Jur a wriaeh repuri. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />nermittee Contact: Williarn Peetz <br />Permittee Name: Ranch Land LLC <br />Address: 3925 Hill Circle <br />Colorado Springs, CO 80904 <br />Phone Number: (719) 492-0266 <br />Fax Number: (719) 473-5494 <br />If you have additional comments andlor information that should be provided to the Division, please provide it <br />below or attach it to P rm along with your written report and ?n>ap. Annual Report instructions are enclosed. <br />C,c rte <br />Signature; of C rate Officer, Owner, or Z si GG <br />3/i 7/o q <br />Date <br />C-d 91,L L-9ZZ-6 LL luoluelle8 eiebuy egO:O l 60 9L qe?