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PERMTTTEE NAME: <br />PEI2MTT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~~ ~~' r <br />ANNUAL FEE and REPORT REQUEST <br />'~Sandco, Inc. <br />/1rI-1986-165 <br />Willow Bend <br />August 27, 2007 <br />$323.00 (Due on or before your anniversary date) <br />La Plata <br /> <br />REC~I!/ED <br />l'JUL X ~ 2007 <br />Division of Reclamation, <br />Mining 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 />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 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 />map. If no new disturbances or reclamation have occurred durinti the previous year and no new chanties to <br />the previous year's man 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 suffrce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David D. Dillon <br />Permittee Name: <br />Address: <br />Sandco, Inc. <br />P.O. Box 4440 <br />Durango, CO 81301 <br />Phone Number: (970) 247-1303 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />elow or attach it to this form along with your written report and map. Annual Report instructions are enclosed, <br />Signature of Corporate Officer, Owner, or Designee <br />/ '" ~ .. <br />Date <br />