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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANN[JAL FEE DUE: <br />COUNTY: <br />~~ ,~ ~P~- <br />ANNUAL FEE and REPORT REQUEST <br />~~ <br />Parkerson Construction Co. a~ <br />M-1986-160 <br />Sunny Side Gravel Pt <br />February 17, 2008. <br />:~ ~`~~ <br />MAR 2 6 2008 l~ <br />~ivisian ter ~cec~a~nation,~ - <br />Mining and Satety / - <br />$$323.00 (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 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 anticipated to occur <br />during the upcoming year, reclamation that will be performed during th-e coming year, tfie dates for"the liegirinirig <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 man 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 durinS 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 since 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 Co. _ <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 this foam along with your written report and map. Annual Report instructions are enclosed. - <br />.~, <br />J.. - <br />Signature of Co orate Officer, Owner, or Designee - <br />D r+' <br />Dat <br />