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<br />STATE <br />DIVISION OF RECUlMAT10N, MINING AND SAFETY <br />Department of Natural Resources ANNUAL FEE and REPORT REQUEST <br />7313 Sherman St., Roorn 215 <br />Den"PEllbtv4l!'~oItl~~hIAME: raig J. Walker Revocable Trust <br />Phone: (303) 866-3567 `- <br />Fnx: I?s&~BAi"kfb1Q.: /1V2-2003-068 <br />OPERATION NAME: Mary's Mountain Gravel Pit <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />- &- <br />SAFETY <br />ANNIVERSARY DATE: February 24, 2007 <br />Bill Owens <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) cOVef"°r <br />Russell George <br />COUNTY: Huerfano Executive Director <br />Ronald W. Cottony <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 pcR1Y14@n31't erator <br />Natur esge7rust~ <br />shall submit the annual-fee; a- yporEand-map-showing the extent of current disturbances to a~fecTreUUUUUU lean , <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 resort and annual report man 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 durine the previous year and no new changes 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 peFmittee contact information. Please verify and make ~any necessary <br />changes: ~ ~ 4. r ~ ~ 111 <br />Permittee Contact: Craig J. Walker SAN ~ ] 2007 <br />~~ ~ n of Reclamation, <br />Mining and Safety <br />Permittee Name: Craig J. Walker Revocable Trust <br />Address: 420 E. 58th Ave., Ste. 200 <br />Denver, CO 80216 <br />Phone Number: (303) 292-5537 <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 />Signature of Qlprpo~~te Officer, Owner, or Designee ; Z'~s~`r- <br />Date <br />Office of Office of <br />Mined Land Reclamation Active and Inactive Mines <br />