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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~ ~ ~4 f <br />ANNUAL FEE and REPORT REQUEST <br />e <br />Elam Construction, Inc. <br />M-1979-166 >/ <br />Bennett's Gravel Pit <br />September 4, 2007 <br />RECEIVED <br />,~ SEP 14 2001 <br />Divls~n of R tlon, <br />M1nIrt9 and <br />$$791.00 (Due on or before your anniversary date) <br />Delta <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 pr~cedingyear,-new disturbances-that-are-anticipated to~ccur--- <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 resort 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 durint the previous year and no new chances to <br />the previous year's map are necessary, then no new map is required, urovided 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: Harold F. Elam <br />Permittee Name: Elam Construction, Inc. <br />Address: 556 Struthers Ave <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-5370 <br />Fax Number: (970) 245-7716 <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 />Signatu • f Corporate facer, Owner, or Designee <br />~-/o '0 7 <br />Date <br />