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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Elam Construction, Inc. <br />M-1991-079 <br />Mule Farm Gravel Pit <br />February 18, 2008 <br />FEa ~ <br />~i~isia 2 2408 <br />Migin9 and Sa ration <br />ty <br />$$791.00 (Due on or before your anniversary date) <br />Mesa <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 annu;~l fee, a report and map showing the extent of current disturbances to affected land, <br />- - = -r-~-reclamation-asecmplisl:ed-ts-date=and-d ~u~r~g <hc-~-r-:,~edng=year',=n~v=dst~bances=that are=arileipate'd=to=occur====`' <br />during the upcoming ye;ar, 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 changes to <br />the previous year's m;ap are necessary. then no new map is reauired, provided that the Operator shall state <br />this in the Annual Rei~ort. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suff ce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: StE;phen Kaspar <br />Permittee Name: Elam Construction, Inc. <br />Address: 556 Struthers Ave <br />Phone Number: <br />Fax Number: <br />Grand Junction, CO 81501-3826 <br />(9'10) 242-5370 <br />(9'70) 245-7716 <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 thi:> form along with your written report and map. Annual Report instructions are enclosed. <br />ignature orpora e i is r caner, or Designee <br />2-,Z. 2 ~ ,0 8~ <br />Date <br />