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.~ 5 ~Pi <br />ANNUAL FEE and REPORT REQUEST R CEIVED <br />PERMITTEE NAME: Grand Junction Concrete Pipe Co. ~B ~ 2 2~~~ <br />PERMIT NO.: M 1981-243 grvision of Redamatian, <br />(~l0ining and Safety <br />OPERATION NAME: S Fruita Grav Pit <br />ANNIVERSARY DATE: February 16, 2007 <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <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`yea%the dates for the 6egihning <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 mao to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to <br />the urevious year's mau are necessary, then no new mao is required, provided that the Oaerator 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: Edward J. Settle <br />Permittee Name: Grand Junction Concrete Pipe Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4604 <br />Fax Number: (970) 243-6703 <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 />Sign- atu~re f Corporate Officer, Owner, or Designee <br />7- 6 =°~ <br />Date <br />