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~~ ~ <br /> ANNUAL FEE and REPORT RE UEST <br /> <br />PERMTTTEE NAME: F <br />Pioneer Sand Company Inc <br />PERMIT NO.: M-1977-057 ,~ <br />OPERATION NAME: Fedinec Pit <br />ANNIVERSARY DATE: November 22, 2007 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <br /> <br />RECEi~iEp <br />~~ 222007 <br />Div~'nin of Reclamation, `~ <br />9 and Safety ,/° <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 />rec amation accomplished to date and during the preceding year, new disturbances that are anticipated-to-occur <br />dune ~` upcom#n~ year,-re~iarnaff`on tlfaTwilYbe performeztdm-ing 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 reuort 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 />maD. If no new disturbances or reclamation have occurred during the previous vear 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 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: Joe Kraig <br />Permittee Name: Pioneer Sand Company Inc <br />Address: P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />Phone Number: (719) 599-8100 <br />Fax Number: {719) 593-0167 <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 />./o .~%,,%,~ ~~T ~ r ~~,s ~~5~ y~~ , <br />Sign re o orporate O ie •, Owner, or Designee <br />~~ -~~ <br />Dat-T-~ <br />