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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE~d REPORT REQUEST <br />y~pf ague Scraper Service, Inc. <br />~4I-2005-032 <br />Sprague Scraper Service Pit <br />August 16, 2007 <br />~~~ <br />RE~~'~~i~~~ <br />BUG 0 2 2007 <br />Div on of Reclamation, <br />Mining and Safety <br />$323.00 (Due on or before your anniversary date) <br />Washington <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 1_and <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 vour 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 during the previous vear and no new chances to <br />the previous year's man are necessary, then no new man 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes; <br />Permittee Contact: Jeffrey Sprague <br />Permittee Name: Sprague Scraper Service, Inc. <br />Address: 610 Ellis Ave. <br />Phone Number: <br />Fax Number: <br />Wray, CO 80758 <br />(970) 332-5807 <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 />Designee <br />Date <br />