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:. ~ ~~L <br />~/ ~ r R ~ REC~BVED <br />A AL FEE and REPORT REQUEST <br />i 3 2007 <br />PERMITTEE NAME: Frank Gilmore JUL 2 <br />Di ision of Reclamation, <br />PERMIT NO.: ~-1983-209 Mining and Safety <br />OPERATION NAME: Benton Dawson Gravel <br />ANNIVERSARY DATE: July 25, 2007 73~3i _ ~. <br />ANNUAL FEE DUE: $~28f00 (Due on or before your anniversary date) <br />COUNTY: Delta <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 sulimittlie annual fee, a report and map showing-tlie extent of current disturbances to affeoted-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 resort 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 during the previous year and no new chances to <br />the urevious year's mau are necessary, then no new maa 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 sufficefor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Frank Gilmore <br />Permittee Name: Frank Gilmore <br />Address: 5998 Sawmill Mesa Road <br />Delta, CO 81416 <br />Phone Number: (970) 874-5157 <br />Fax Number: <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 />--~ ~ k-~ <br />Signature of Corporate Officer, Owner, or Designee <br />~~~lo~ <br />Date <br />