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~ b ~ ~'~) <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: +~Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: ~ M-1980-022 <br />OPERATION NAME: Preston Pit Extension ,~ ~,,~ <br />A1~TNIVERSARY DATE: February 2, 2008 ~FEg 0 ~ ZOOg <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) ®i~iGn c~ y;oc~~;r~ation, <br />COUNTY: Mesa /Mirnn9 and 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 durir_g the-precedi:~g year,- new disturbances that are anticipated -te 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 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 chances to <br />the previous year's map are necessary, then no new map is reauired, 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: Brent W. Kerr <br />Permittee Name: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />Address: P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5946 <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 />/~ ./tR~-~~' lx~ I i .efw <br />Signature of Corporate Officer, Owner, or Designee <br />4 ~,,....~ ~, . ~ l . a ~vs <br />Date <br />