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999 <br /> ANNUAL FEE and REPORT REOUEST <br /> RE0E Vs® <br /> PERMIT-FEE NAME: B & B Excavating, Inc. <br /> PERMIT NO.: M-1997-026 SEP 1 2 2DD1 <br /> OPERATION NAME: Carol Ann Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: September 8,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Eagle <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 map to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suf ce for a written report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> PermitteeContact: Scau41eouw J aQkIX'7 <br /> Permittee Name: B & B Excavating, Inc. [� n <br /> Address: v n Dra.Uor dQ P, d. 60y, <br /> Phone Number: (970) 926-3311 <br /> Fax Number: (970) 926-2344 <br /> If you have additional comments and/or information that should be provided to the Division, please provide it <br /> below or attach <br /> it to this form along with your written report and map. Annual Report instructions are enclosed. <br /> -Z41 F-4 <br /> Signature of Corporate Officer or Owner <br /> 7-a/ <br /> Date <br /> M9PERM"IASTERDOCUMENTSW-AF-01 <br />