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C~/~ <br /> j~ fR~ <br /> ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: ~ <br />Grand Junction Pipe & Supply Co. <br />PERMIT NO.: // <br />`~M-1998-105 <br />OPERATION NAME: Delta Paving Gravel Pit <br />ANNIVERSARY DATE: August 6, 2007 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Delta <br />R~~~~~~p <br />BUG 022007 <br />D~ivi~on of R~amation, <br />"""O1n9 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 />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />~rmg t e upcoming year, rec amation tt ah t will"fie peifo~3uring tfie coming- y~he dates~'or th~ginnmg - -- ' <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 report mao 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 during the previous veer and no new chances to <br />the previous year's mao 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pennittee Contact: Edward J. Settle <br />Permittee Name: Grand Junction Pipe & Supply 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 />~. <br />Signature of C rporate Officer, Owner, or Designee <br />7-30 -~7 <br />Date <br />