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<br /> P~ ~~C~ <br /> ANNUAL FEE and REPORT REQUEST <br /> ~~ <br />PERMITTEE NAME: Elam Construction, Inc. <br />PERMIT NO.: M-2002-111 <br />OPERATION NAME: Gilsonite Gravel Pit <br />ANNIVERSARY DATE: October 21, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br />RECEIVED <br />p~ pg ZOUi `~ <br />Division ° and S ety n <br />Mining <br />shall submit the annual fee, a report and map showing the extent of cunent 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 durinc the previous vear and no new chances to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note [hat 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: Harold F. Elam <br />Permittee Name: Elam Construction, Inc. <br />Address: 556 Struthers Ave <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-5370 <br />Fax Number: (970) 245-7716 <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 />cc.r.>' <br />igna of Corporate O ~cer, Owner, or Designee <br />S. ,Z,ov7 <br />Date <br />