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ip'p +- Q e <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Montrose County <br />PERMIT NO.: M-1992-017 ?/ <br />OPERATION NAME: BLM/West End Pit <br />ANNIVERSARY DATE: April 24, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <br />P-W-CoV <br />MAR 3 0 2009 <br />Division Or Kec1amati01*9 and Safetyon, <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-shoving--the extent==ef-cunvnt--disturbances-to-affe <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 may 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 durine 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 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: Brian Wilson <br />Permittee Name: Montrose County <br />Address: Attn: Engineering Dept <br />161 S Townsend Ave <br />Montrose, CO 81401 <br />Phone Number: (970) 252-7000 <br />Fax Number: (970) 252-7010 <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 Corporate Officer, Owner, or Designee <br />Date <br />M:\PERMITIMASTERDOCUMENTS\M-AF-04