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k e 3 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />&NNUAL FEE and REPORT REQUEST <br />k Duran & Pearce Contractors, Inc. <br />M-1990-140 <br />Martin Pit 1-A <br />December 18, 2010 <br />i11/M <br />DEC 0 6 2010 <br />AA F4 and saftty <br />$323.00 (Due on or before your anniversary date) <br />Moffat <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 yd`ar,-reclamation "that- will be performe-dduririg-the coming year,?he dates forie beginning of active operations, and the date active operations ceased for the <br /> year, if any. <br />Please attach your revised written annual report and annual report may 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 during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately label map that clearly delineates and includes the <br />above elements may since for a written report. <br />- NO Alew leis 1-hall"C 114.1 f it ^ 0 <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jim Duran <br />Permittee Name: Duran & Pearce Contractors, Inc. <br />Address: 504 Stock Dr. <br />P.O. Box 1331 <br />Craig, CO 81626 <br />Phone Number: (970) 824-4014 <br />Fax Number: <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 />Owner, or Designee <br />Date