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. ~ b~ <br />~:~~°i <br />ANNUAL FEE and REPORT REQUEST //2 <br />PERMITTEE NAME: /Base Products d~~~'= ~l OY h® <br />PERMIT NO.: ~M-1994-053 /AUG 1 D 2007 <br />OPERATION NAME: Base Product Gravel Pit 1 ~lv~L' nor. of Reclamation, <br />7/Mining and Safety <br />ANNIVERSARY DATE: September 13, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <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 />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 report and annual report mau to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, reuort, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances 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 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 Tony F. Appelhanz <br />Permittee Name: Base Products <br />Address: 62339 W. LaSalle Rd. <br />Montrose, CO 81401 <br />Phone Number: (970) 249-3061 <br />Fax Number: <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 />i <br />Signatur Corporate facer, Own , or Designee <br />-5-0'7 <br />Date <br />