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~i <br /> <br />~F ~-2~C <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Gary Rindi'rle Construction, Inc. RECEIVED <br />PERMIT NO.: M-2001-088 // S~ 26 Z0~7 <br />OPERATION NAME: Upland Gravel Olvlalon of Reolematlon, <br />ANNIVERSARY DATE: October 17, 2007 Mining end 8efsty <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <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 />--shalt-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 mau 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 veer 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 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: Gary Rinderle <br />Permittee Name: Gary Rinderle Construction, Inc. <br />Address: 542 33 Rd. <br />P.O. Box 1380 <br />Clifton, CO 81520 <br />Phone Number: (970) 434-0510 _-= --- ------ <br />Fax Number: (970) 434-6510 <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 />Officer, Owner, or Designee <br />Date <br />