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1` <br /> ANNUAL FEE and REPORT REQUEST <br /> Der+~l~/FD <br />PERMITTEE NAME: AZCO Construction, Inc. AUG 2 Q 2OOT <br />PERMIT NO.: M-2004-029 Drvis~on of Reclamation <br /> <br />OPERATION NAME: <br />AZCO Pit , <br />Mininy and Safety <br />ANNIVERSARY DATE: September 24, 2007 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <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-dis[urbances-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 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. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the previous year's mac are necessary, then no new mac 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: Ro Walker <br />Permittee Name: AZCO Construction, Inc. <br />Address: 2055 US Highway 50 <br />Penrose, CO 81240 <br />Phone Number: (719) 372-6872 <br />Fax Number: (719) 372-0418 <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 />Si ' a~~~re~o~f Corporate Officer, Owner, or Designee <br />!I/ s~vz~ ~ <br />Date ~ <br />