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J' <br />~~ ~ 1 , L~ <br /> ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Warren & Sally Wilcox dba Gunnison Gravel &Earthmoving <br />PERMIT NO.: M 1978-305 ~ ~ ~ <br />f <br />OPERATION NAME: Dickerson Pit ! <br />ANNIVERSARY DATE: February 22, 2008 /FEB 4 6 2008 <br />ANNiJAL FEE DUE: $$791.00 (Due on or before your anniversary date) vision of keciarnatton, <br /> Mining and Safety <br />COUNTY: Gunnison <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_disturbanc_es_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 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 durinE 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: Warren Wilcox <br />Permittee Name: Warren & Sally Wilcox dba Gunnison Gravel & Earthmoving i;L~ <br />Address: _ P.O..Box 42 <br />Gunnison, CO 81230 <br />Phone Number: (970) 641-3088 <br />Fax Number: (970) 641-5811 <br />have additional comments and/or information that should be provided to the Division, please provide it <br />or a ch it is form along with your written report and map. Annual Report instructions are enclosed. <br />`-~ <br />are of orporate fficer, Owner, or Designee <br />~~~ o $ <br />Date <br />