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RFCE~VEp <br />ANNUAL FEE and REPORT REQUEST SEF 267007 <br />Dtvislon o! R <br />PERMITTEE NAME: Asphalt Gravel Products, Inc. Mining and ~~tlon, <br />PERMIT NO.: M-1978-271 <br />OPERATION NAME: Garrett Pit <br />ANNNERSARY DATE: October 30, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Conejos <br />-' According to C:R.S-34=32:5-r16'orC: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 vour revised written annual report and annual resort maa to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, renort, and associated <br />man. If no new disturbances or reclamation have occurred during the previous vear and no new chances to <br />the previous year's moo are necessary, then no new moo is required. nrovided 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: Rock I. Southway <br />Permittee Name: Asphalt Grave] Products, Inc. <br />Address: 117 White Pine Dr. <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-5103 <br />Fax Number: (719) 589-5522 <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 />SignCorp~ er, or Designee <br />9~ ~~~ 0"7 <br />Date <br />