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r <br />ANNUAL FEE an REPORT REQUEST <br />/':?- <br /> <br />RECEIVED <br />PERMITTEE NAME: Kirkland Construction, RLLP "UL 3 9 2009 <br />PERMIT NO.: M-1998-038 <br />Division ofa d Safe y n <br />OPERATION NAME: Two Rivers Mining <br />ANNIVERSARY DATE: August 3, 2009 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <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 />reclamation accomplished-:.to date and during the preceding year, new disturbances that are anticipated 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 map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred no new disturbances or reclamation have occurred during previous year and no new changes to year and no new changes to <br />the previous vear's map are necessarv. 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 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: Joe C. Baxter <br />Permittee Name: KirKland Construction, RLLP <br />Address: P.O. Box 580 <br />2101 Main Street <br />Rye, CO 81069 <br />Phone Number: (719) 489-3385 <br />Fax Number: (719) 489-2265 <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 />G- 6_? <br />Si ure of Corporate Officer, O?vner, or Designee <br />Date