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~ ~ `~ <br />/ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: / Brannan Sand & Gravel Company RECEIVED <br />PERMIT NO.: L M-1980-183 JAN 0 2 2001 <br />OPERATION NAME: Pit 29 Ivlslon of Redomotion, <br />Mining end Safety <br />ANNNERSARY DATE: January 8, 2007 <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) <br />COUNTY: Adams <br />~~- <br />oz-of- o`I <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showin the extent of current disturbances to affected land,_ _ __ <br />reclamati accompli-slied'to Sate and during the pre6eding'year, new ~stur~ances t at are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming yeaz, 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 resort and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />map. If no new disturbances or reclamation have occurred durinc the arevious veer and no new chances to <br />the previous year's mao are necessary. then no new maa is required, provided that the Operator shall state <br />this in the Annual Resort. 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 pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Fred L Marvel <br />Permittee Name: Brannan Sand & Gravel Company <br />Address: 2500 E. Brannan Way <br />Denver, CO 80229 <br />Phone Number: (303) 534-1231 <br />Fax Number: (303) 534-1236 <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 />S gnature of Corp2te Officer, O/' per, or Designee <br />~~ _ ~ cJ ~ ~ C~j <br />Date <br />