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,~~ ~ R~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Parkerson Construe/tion, Inc. <br />PERMIT NO.: M-1981-229 ~/ <br />OPERATION NAME: Valley Vista Pit <br />ANNIVERSARY DATE: December 18, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br />~~~~ <br />d~~ a .~ ~ <br />3 zoor ~ <br />bl'u-'c~tan of ~'~ci~mation,~ <br />~ilifFi~ Intl 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 antici~ated_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, reuort, and associated <br />map. If no_new disturbances or reclamation have occurred durin the previous vear and no new changes to <br />the urevious year's man are necessary, then no new man 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Alan Parkerson <br />Permittee Name: Parkerson Construction, Inc. <br />Address: 710 S. 15th St <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-8134 <br />Fax Number: (970) 242-8977 <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 ~s form along with your written report and map. Annual Report instructions are enclosed. <br />,~ <br />Signature of C ~ orate Officer, Owner, or Designee <br />Dat ~~~~-s-7 <br />