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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNiJAL FEE DUE: <br />COUNTY: <br />Q,n~tK,b.Q ~"~c. <br />ANNUAL FEE and REPORT RE~QJU~EST <br />Hardrock Sand & Gravel <br />M-1977-443 ti~ <br />Moon Pit No 2 <br />November 8, 2007 <br />~~~a~ . <br />®~~ ~ _ <br />®?®®' ~ <br />Division ®f Mect~rn~?ion <br />Mining any, !'~~etv ' l~ <br />$$323.00 (Due on or before your anniversary date) <br />Moffat <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 />-- __ rreclamation_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 ad tes 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 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 during the previous year and no new changes 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 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: Pat J. Weber <br />Permittee Name: Hardrock Sand & Gravel <br />Address: P.O. Box 141 <br />Phone Number: <br />Fax Number: <br />Craig, CO 81626 <br />(970) 824-4053 <br />(970) 824-4053 <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 />Si ture of orporate Officer, Owner, or Designee <br />~~- ~ -G-7 <br />Date <br />/lia ,~~iV~`y ~h/S/~~~ <br />~Y,t~~Ci ~C- /1rP cv ~1 !~/~ <br />