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~~ <br />PERMTI'TEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />~~Dilleys Sand & Gravel <br />M-1986-105 <br />Vondy Pit <br />August 29, 2006 <br /> <br />~JUL 2 42006 <br />~Givisian of Minerals and GeoloBY <br />$281.00 (Due on or before your anniversary date) <br />Morgan <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 cturent disturbances to affected land, <br />rec amaUon accomplished toVda'te and during the pieiSeding year,-iiew disstuibances 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 reuort maa 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 (All are required regardless of the level of disturbance or absence of disturbance during the previous <br />year). Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />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: Vernon Dilley <br />Permittee Name: Dilleys Sand & Gravel <br />Address: 1914 Edmunds St. <br />P.O. Box 125 <br />Brush, CO 80723 <br />Phone Number: <br />Fax Number: <br />(970)842-2810 <br />(970)842-2284 <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 />Signature of Corporate Officet Owner, or Designee <br />7-~a-oG <br />Date <br />