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<br /> AF~,2QT <br /> ANNUAL FEE and REPORT REQUEST <br /> ~ <br />PERMITTEE NAME: Tamrock Gravel/ <br />PERMIT NO.: M-2001-068 / <br />OPERATION NAME: Bottomless Pit <br />ANNNERSARY DATE: September 17, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Las Animas <br />RECENED <br />SEP T 8 2007 / <br />Division of ReGamatlon ,p <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 />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 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 />mao. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to <br />the previous year's map are necessary, then no new mao 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: Brent Tamburelli <br />Permittee Name: <br />Address: <br />Tamrock Gravel <br />137 Plum <br />Trinidad, CO 81082 <br />Phone Number: (719) 846-3034 <br />Fax Number: (719) 846-7842 <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 /u~r written report and map. Annual Report instructions are enclosed. <br />~,/dry // Gln~-Lo2Gr/l~ ' <br />Signature of Corporate Officer, Owner, or Designee <br />/ ~~~- <br />Date <br />