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%~: APT <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: -- Snowstorm Sand & Gravel, LLC <br />PERMIT NO.: ~M-1983-084 <br />OPERATION NAME: Snowstorm Placer <br />ANNIVERSARY DATE: July 28, 2007 <br />~- <br />ANNUAL FEE DUE: $$ _ ~0 (Due on or before your anniversary date) <br />COUNTY: Park <br />/`E-~"c <br />RE~°~'la ~,~~ <br />~AUG 1 ~ 2007 <br />,9(v:SCO ...~~ion, <br />."."ir.. .~ 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 />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 vour 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 during the previous year and no new changes to <br />the previous year's man are necessary. then no new moo is required, urovided 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: 4~afid-~eFnes- <br />///, Er~;~ ~/u.t,~v~s <br />Permittee Name: Snowstorm Sand & Gravel, LLC <br />Address: ~ ^.^-r-o~S <br />S„o Is~o.~, sa~~ ~ G.-a~eP, «c <br />PD ~OX ~r`.s® <br /> <br />Phone Number: iOSiT <br />Fax Number: (-7~9}-836~~92fr- <br /> <br />P~~-~~8--asa l <br />~~m- yes'-~~~~ <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 />~. ~a,.c ~.y~t~ <br />Signature of Corporate C ficer, Owner, or Designee <br />m&'-/3-mom <br />Date <br />